Provider Demographics
NPI:1770040685
Name:SKALAN LLC
Entity Type:Organization
Organization Name:SKALAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-970-0336
Mailing Address - Street 1:14917 SMITTER RESERVE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2205
Mailing Address - Country:US
Mailing Address - Phone:407-970-0336
Mailing Address - Fax:
Practice Address - Street 1:14917 SMITTER RESERVE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2205
Practice Address - Country:US
Practice Address - Phone:407-970-0336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty