Provider Demographics
NPI:1932658648
Name:DANIEL CALVA-CERQUEIRA, M.D., P.A.
Entity Type:Organization
Organization Name:DANIEL CALVA-CERQUEIRA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVA-CERQUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-449-6160
Mailing Address - Street 1:7300 N KENDALL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7840
Mailing Address - Country:US
Mailing Address - Phone:786-270-3900
Mailing Address - Fax:305-925-8100
Practice Address - Street 1:7300 N KENDALL DR STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7840
Practice Address - Country:US
Practice Address - Phone:786-270-3900
Practice Address - Fax:305-925-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120264208200000X
2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015586400Medicaid
FL015586400Medicaid