Provider Demographics
NPI:1154584928
Name:MCCALISTER, DENISE RENEE
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:RENEE
Last Name:MCCALISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 W IDLEWILD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-8015
Mailing Address - Country:US
Mailing Address - Phone:813-901-3437
Mailing Address - Fax:
Practice Address - Street 1:5520 WEST IDLEWILD AVENUE
Practice Address - Street 2:FAMILY SUPPORT CENTER
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-8015
Practice Address - Country:US
Practice Address - Phone:813-901-3437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator