Provider Demographics
NPI:1861585721
Name:KALOMIRIS, DIMITRIOS MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DIMITRIOS
Middle Name:MICHAEL
Last Name:KALOMIRIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2600 LAKE LUCIEN DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7233
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-875-0518
Practice Address - Street 1:1300 NW 17TH AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2578
Practice Address - Country:US
Practice Address - Phone:561-819-0857
Practice Address - Fax:561-549-0173
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME58653207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276920400Medicaid
FL276920400Medicaid