Provider Demographics
NPI:1033401625
Name:CALIXTE, NAHOMY (MD)
Entity Type:Individual
Prefix:
First Name:NAHOMY
Middle Name:
Last Name:CALIXTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16966 CAGAN RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-9656
Mailing Address - Country:US
Mailing Address - Phone:352-536-8761
Mailing Address - Fax:352-536-8768
Practice Address - Street 1:16966 CAGAN RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714-9656
Practice Address - Country:US
Practice Address - Phone:352-536-8761
Practice Address - Fax:352-536-8768
Is Sole Proprietor?:No
Enumeration Date:2011-05-14
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127480208800000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017585500Medicaid
FLIP380ZMedicare UPIN