Healthcare Provider Details

I. General information

NPI: 1932658648
Provider Name (Legal Business Name): DANIEL CALVA-CERQUEIRA, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N KENDALL DR STE 201
MIAMI FL
33156-7840
US

IV. Provider business mailing address

7300 N KENDALL DR STE 201
MIAMI FL
33156-7840
US

V. Phone/Fax

Practice location:
  • Phone: 786-270-3900
  • Fax: 305-925-8100
Mailing address:
  • Phone: 786-270-3900
  • Fax: 305-925-8100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME120264
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL CALVA-CERQUEIRA
Title or Position: PRESIDENT
Credential: MD
Phone: 915-449-6160