Provider Demographics
NPI:1912032954
Name:CHARLES KALSTONE MD PA
Entity Type:Organization
Organization Name:CHARLES KALSTONE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KALSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-667-4511
Mailing Address - Street 1:6141 SUNSET DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5039
Mailing Address - Country:US
Mailing Address - Phone:305-667-4511
Mailing Address - Fax:305-667-3706
Practice Address - Street 1:6141 SUNSET DR
Practice Address - Street 2:SUITE 401
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5039
Practice Address - Country:US
Practice Address - Phone:305-667-4511
Practice Address - Fax:305-667-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0016075207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty