Provider Demographics
NPI:1457325698
Name:KALINA, SCOTT LESLIE (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LESLIE
Last Name:KALINA
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 1:5300 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2387
Mailing Address - Country:US
Mailing Address - Phone:561-227-5270
Mailing Address - Fax:561-863-2806
Practice Address - Street 1:11112 NANTUCKET BAY CT
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8813
Practice Address - Country:US
Practice Address - Phone:561-333-6529
Practice Address - Fax:561-333-6529
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1270Medicaid
FL1270Medicaid
FLCO5197Medicare UPIN