Healthcare Provider Details

I. General information

NPI: 1891799482
Provider Name (Legal Business Name): DAVID J CALDARELLA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3955 INDIAN RIVER BLVD
VERO BEACH FL
32960-4814
US

IV. Provider business mailing address

3955 INDIAN RIVER BLVD STE 100
VERO BEACH FL
32960-4845
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-2330
  • Fax: 772-569-2630
Mailing address:
  • Phone: 772-569-2330
  • Fax: 772-569-2630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberDPM00344
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: