Organization
KEITH J. KALISH DPM,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH JAY KALISH DPM (OWNER)
(772) 567-0111
Entity
Organization
Contact information
Practice address
1285 36TH ST, SUITE 203, VERO BEACH, FL 32960-4885
(772) 567-0111
(772) 567-7117
Mailing address
1285 36TH ST, SUITE 203, VERO BEACH, FL 32960-4885
(772) 567-0111
(772) 567-7117
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO 001790
STATE LIC#
FL
Enumeration date
12/14/2006
Last updated
08/22/2020
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