Provider Demographics
NPI:1821052739
Name:CALVO, ALDO A (DO)
Entity Type:Individual
Prefix:
First Name:ALDO
Middle Name:A
Last Name:CALVO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-761-1020
Mailing Address - Fax:954-761-9983
Practice Address - Street 1:1101 NW 1 STREET
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311
Practice Address - Country:US
Practice Address - Phone:954-761-1020
Practice Address - Fax:954-761-9983
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004743A207Q00000X
NE1419207Q00000X
IL036.139269207Q00000X
MDH80598207Q00000X
LA300622207Q00000X
FLOS7568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46627OtherBCBS
FL253634000Medicaid
FL253634000Medicaid
G94956Medicare UPIN