MEDICARE: DR. DYLAN M CALDWELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	ME80596	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	58881	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1053395715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DYLAN M CALDWELL MD

Provider Business Mailing Address
First Line	:	3581 1ST AVE NW
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34120-2707
Country	:	US
Telephone Number	:	239-537-2318
Fax Number	:	239-842-1213

Provider Business Practice Location Address
First Line	:	200 AVIATION DR N STE 9
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34104-3501
Country	:	US
Telephone Number	:	239-206-8885
Fax Number	:	239-842-1213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	02/15/2023

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