Provider Demographics
NPI:1699849232
Name:KALAN, PRAKASH POPAT (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAKASH
Middle Name:POPAT
Last Name:KALAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5728 MAJOR BLVD
Mailing Address - Street 2:SUITE 528
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7945
Mailing Address - Country:US
Mailing Address - Phone:407-352-2542
Mailing Address - Fax:407-352-2547
Practice Address - Street 1:5728 MAJOR BLVD
Practice Address - Street 2:SUITE 528
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7945
Practice Address - Country:US
Practice Address - Phone:407-352-2542
Practice Address - Fax:407-352-2547
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 74866207R00000X
FLME74866208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258643600Medicaid
FLE2868YMedicare PIN
FL258643600Medicaid