Healthcare Provider Details

I. General information

NPI: 1467482091
Provider Name (Legal Business Name): OSCAR M MENDOZA-CALIX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PLACE SUITE 402
HIALEAH FL
33012-3147
US

IV. Provider business mailing address

9821 SW 73RD CT
MIAMI FL
33156-3112
US

V. Phone/Fax

Practice location:
  • Phone: 305-907-8526
  • Fax: 305-907-0228
Mailing address:
  • Phone: 305-510-2638
  • Fax: 305-662-7879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME55656
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberME 55656
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME55656
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME55656
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME55656
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME55656
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: