Provider Demographics
NPI:1477700151
Name:CALDERON, CALIXTO FLORENCIO (MD)
Entity Type:Individual
Prefix:
First Name:CALIXTO
Middle Name:FLORENCIO
Last Name:CALDERON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4891 SW 35TH TER
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-8266
Mailing Address - Country:US
Mailing Address - Phone:786-263-4127
Mailing Address - Fax:786-263-4442
Practice Address - Street 1:1321 NW 13TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1603
Practice Address - Country:US
Practice Address - Phone:786-263-4127
Practice Address - Fax:786-263-4442
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65111207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine