Provider Demographics
NPI:1326487190
Name:CALLANDER, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CALLANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 KINGSLEY AVE STE 1900
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4451
Mailing Address - Country:US
Mailing Address - Phone:904-276-2549
Mailing Address - Fax:904-276-9235
Practice Address - Street 1:1887 KINGSLEY AVE STE 1900
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4451
Practice Address - Country:US
Practice Address - Phone:904-276-2549
Practice Address - Fax:904-276-9235
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT203620208600000X
FLME139862208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery