Healthcare Provider Details

I. General information

NPI: 1679839310
Provider Name (Legal Business Name): CALIXTE MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8910 MIRAMAR PKWY SUITE 117
MIRAMAR FL
33025-4100
US

IV. Provider business mailing address

8910 MIRAMAR PKWY SUITE 117
MIRAMAR FL
33025-4100
US

V. Phone/Fax

Practice location:
  • Phone: 954-442-6988
  • Fax: 954-441-2859
Mailing address:
  • Phone: 954-442-6988
  • Fax: 954-441-2859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. HAROLD CALIXTE
Title or Position: PRESIDENT
Credential:
Phone: 954-442-6988