Provider Demographics
NPI:1942593132
Name:THOMAS A. CALECA MDPA
Entity Type:Organization
Organization Name:THOMAS A. CALECA MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:CALECA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-442-5114
Mailing Address - Street 1:610 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3336
Mailing Address - Country:US
Mailing Address - Phone:727-442-5114
Mailing Address - Fax:727-442-6540
Practice Address - Street 1:610 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3336
Practice Address - Country:US
Practice Address - Phone:727-442-5114
Practice Address - Fax:727-442-6540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-20
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46385207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFC043AMedicare PIN