Provider Demographics
NPI:1679839310
Name:CALIXTE MEDICAL CENTER INC.
Entity Type:Organization
Organization Name:CALIXTE MEDICAL CENTER INC.
Other - Org Name:YOLAINE M CHAMBLIN, MD, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALIXTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-442-6988
Mailing Address - Street 1:8910 MIRAMAR PKWY
Mailing Address - Street 2:SUITE 117
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4100
Mailing Address - Country:US
Mailing Address - Phone:954-442-6988
Mailing Address - Fax:954-441-2859
Practice Address - Street 1:8910 MIRAMAR PKWY
Practice Address - Street 2:SUITE 117
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4100
Practice Address - Country:US
Practice Address - Phone:954-442-6988
Practice Address - Fax:954-441-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty