Healthcare Provider Details

I. General information

NPI: 1669683959
Provider Name (Legal Business Name): ANTHONY JOHN CAVALIERI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 3014
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

11477 BITOLA DR
ODESSA FL
33556-3767
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4225
  • Fax: 513-636-2511
Mailing address:
  • Phone: 248-835-4042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME175934
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301097915
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number60595
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number01095870A
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.121628
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: