Provider Demographics
NPI:1780726851
Name:CALZADA, MANUEL E (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:E
Last Name:CALZADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7768
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7768
Mailing Address - Country:US
Mailing Address - Phone:787-874-2912
Mailing Address - Fax:787-874-1324
Practice Address - Street 1:#31 RD,13.4 KM BARRIO PENA POBRE
Practice Address - Street 2:
Practice Address - City:NAGUABO
Practice Address - State:PR
Practice Address - Zip Code:00718
Practice Address - Country:US
Practice Address - Phone:787-874-2912
Practice Address - Fax:787-874-1324
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10746208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics