Healthcare Provider Details

I. General information

NPI: 1427166594
Provider Name (Legal Business Name): MIRAMAR PODIATRY AND SURGERY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 03/20/2012
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: 954-442-6100
  • Fax: 954-442-6202
Mailing address:
  • Phone: 954-442-6100
  • Fax: 954-442-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO 3243
License Number StateFL

VIII. Authorized Official

Name: DR. NANCY ALEXIS-CALIXTE
Title or Position: PODIATRIST
Credential: DPM
Phone: 954-442-6100