Provider Demographics
NPI:1659166908
Name:OSCAR CALVINO LLC
Entity type:Organization
Organization Name:OSCAR CALVINO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-638-3162
Mailing Address - Street 1:18280 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-3079
Mailing Address - Country:US
Mailing Address - Phone:786-838-9285
Mailing Address - Fax:
Practice Address - Street 1:18280 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-3079
Practice Address - Country:US
Practice Address - Phone:786-838-9285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty