Provider Demographics
NPI:1669705513
Name:CALVO, BRYAN (DPM)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:CALVO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7190 SW 87TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2507
Mailing Address - Country:US
Mailing Address - Phone:305-595-7808
Mailing Address - Fax:786-518-2513
Practice Address - Street 1:7190 SW 87TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2507
Practice Address - Country:US
Practice Address - Phone:305-595-7808
Practice Address - Fax:786-518-2513
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3401213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery