Organization Active NPI

Kala Medical, Corp.

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1053748517
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME103920 Issued in FL
Legal business name
KALA MEDICAL, CORP.
Practice address
900 SW 97TH Ave
Miami, FL 33174-2935
Phone
(786) 507-5530
Fax
(786) 398-4641
NPI assigned
Sep 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Alexangel Santana, M.D.NPI 1578771697
Title
President
Phone
(305) 753-7028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME103920 FL Primary

Addresses

Primary practice location

900 SW 97TH Ave
Miami, FL 33174-2935

Mailing address

900 SW 97TH Ave
Miami, FL 33174-2935
Phone (786) 507-5530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131217001532 FL Part B Supplier - Clinic/Group Practice 8123255239 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

11760 SW 40th St
Ste 622A
Miami, FL 33175
Phone (305) 559-9860

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630627200000",
    "number": "1053748517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 SW 97TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331742935",
            "telephone_number": "786-507-5530",
            "fax_number": "786-398-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SW 97TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331742935",
            "telephone_number": "786-507-5530",
            "fax_number": "786-398-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALA MEDICAL, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A",
        "authorized_official_last_name": "SANTANA",
        "authorized_official_first_name": "ALEXANGEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-753-7028",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME103920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.