Provider Demographics
NPI:1184947558
Name:HENRY CALAS M.D. P.A.
Entity type:Organization
Organization Name:HENRY CALAS M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:772-223-5345
Mailing Address - Street 1:827 SE 5TH ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2401
Mailing Address - Country:US
Mailing Address - Phone:772-223-5345
Mailing Address - Fax:772-223-0960
Practice Address - Street 1:827 SE 5TH ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2401
Practice Address - Country:US
Practice Address - Phone:772-223-5345
Practice Address - Fax:772-223-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL377712000Medicaid
FL377712000Medicaid