Provider Demographics
NPI:1467482091
Name:MENDOZA-CALIX, OSCAR M (MD)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:M
Last Name:MENDOZA-CALIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9821 SW 73RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3112
Mailing Address - Country:US
Mailing Address - Phone:305-510-2638
Mailing Address - Fax:305-662-7879
Practice Address - Street 1:1400 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-6034
Practice Address - Country:US
Practice Address - Phone:305-510-2638
Practice Address - Fax:305-662-7879
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 55656207LC0200X
FLME55656207R00000X, 208600000X, 208VP0014X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26205Medicare UPIN