Provider Demographics
NPI:1295476745
Name:KALAIGER, ABDUL MUKHTADIR
Entity type:Individual
Prefix:
First Name:ABDUL MUKHTADIR
Middle Name:
Last Name:KALAIGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 HIGHLAND PARK BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1639
Mailing Address - Country:US
Mailing Address - Phone:813-651-1085
Mailing Address - Fax:813-657-4274
Practice Address - Street 1:4315 HIGHLAND PARK BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1639
Practice Address - Country:US
Practice Address - Phone:813-651-1085
Practice Address - Fax:813-657-4274
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME172287207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty