Healthcare Provider Details

I. General information

NPI: 1962433359
Provider Name (Legal Business Name): NANCY ALEXIS-CALIXTE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
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 SUITE117
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 Number3243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: