Provider Demographics
NPI:1306927611
Name:KALOSIS, JOHN J (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:KALOSIS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:19531 COCHRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-2081
Mailing Address - Country:US
Mailing Address - Phone:941-979-5602
Mailing Address - Fax:941-743-2121
Practice Address - Street 1:2343 AARON ST
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5305
Practice Address - Country:US
Practice Address - Phone:941-629-2900
Practice Address - Fax:941-629-6920
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-10-31
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Provider Licenses
StateLicense IDTaxonomies
FLOS6948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57116OtherBCBS
FLF25886Medicare UPIN
FL57116ZMedicare PIN