Provider Demographics
NPI:1689897340
Name:KALARICKAL, ZACHARIAS J
Entity Type:Individual
Prefix:DR
First Name:ZACHARIAS
Middle Name:J
Last Name:KALARICKAL
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 1:2400 AMBERSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-8716
Mailing Address - Country:US
Mailing Address - Phone:813-991-5100
Mailing Address - Fax:813-973-1727
Practice Address - Street 1:28965 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4219
Practice Address - Country:US
Practice Address - Phone:813-991-5100
Practice Address - Fax:813-973-1727
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN151861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice