Healthcare Provider Details

I. General information

NPI: 1790093458
Provider Name (Legal Business Name): PAIGE KALIKA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2010
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST 5TH FLOOR (M851)
MIAMI FL
33136-2137
US

IV. Provider business mailing address

1150 NW 14TH ST 5TH FLOOR (M851)
MIAMI FL
33136-2137
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-7505
  • Fax:
Mailing address:
  • Phone: 305-243-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberOS11103
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberOS11103
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: