Basic Information
| Provider Information | |||||||||
| NPI: | 1427221191 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KALINA | ||||||||
| FirstName: | CLIFFORD | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | AUD. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6705 RED ROAD | ||||||||
| Address2: | SUITE 704 | ||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331433622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056660203 | ||||||||
| FaxNumber: | 7865331502 | ||||||||
| Practice Location | |||||||||
| Address1: | 6705 RED ROAD | ||||||||
| Address2: | SUITE 704 | ||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331433622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056660203 | ||||||||
| FaxNumber: | 7865331502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2008 | ||||||||
| LastUpdateDate: | 05/27/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY 1193 | FL | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | AY 1193 | 01 | FL | STATE AUDIOLOGY LICENSE | OTHER | 600392300 | 05 | FL | MEDICAID |