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Individual

AJAY KALRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6821 PALISADES PARK CT, FORT MYERS, FL 33912-7131
(239) 936-8555
(239) 936-5611
Mailing address
6821 PALISADES PARK CT, FORT MYERS, FL 33912-7131
(239) 936-8555
(239) 936-5611

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
ME85409
FL
2086S0129X
Vascular Surgery Physician
Primary
ME85408
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010065906
RAILROAD MEDICARE
01
16004
BLUE CROSS BLUE SHIELD FL
05
2650487000
FL
01
7428352
AETNA
Enumeration date
08/31/2005
Last updated
08/29/2014
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