Provider Demographics
NPI:1023218450
Name:CAIO GONCALVES PA
Entity Type:Organization
Organization Name:CAIO GONCALVES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONCALVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-271-3131
Mailing Address - Street 1:11030 SW 88TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1220
Mailing Address - Country:US
Mailing Address - Phone:305-271-3131
Mailing Address - Fax:305-595-8043
Practice Address - Street 1:11030 SW 88TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1220
Practice Address - Country:US
Practice Address - Phone:305-271-3131
Practice Address - Fax:305-595-8043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty