Individual
GIRIDHAR P KALAMANGALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0236
(352) 273-5550
Mailing address
PO BOX 100236, GAINESVILLE, FL 32610-0236
(352) 273-5550
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
FTL 41266
TX
2084N0400X
Neurology Physician
FTL 42176
TX
2084N0400X
Neurology Physician
FTL 42588
TX
2084N0400X
Neurology Physician
Primary
MFC1789
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021663900
—
FL
05
—
181044201
—
TX
01
—
8R6146
BCBS
TX
01
—
JB421Z
MEDICARE
FL
Enumeration date
05/25/2006
Last updated
07/21/2022
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