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General NPI Number Information
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NPI Number | 1215021944
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Entity Type | Individual
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Provider Name | LEONEL MARTIN CALDERON M.D
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 750 S FEDERAL HWY
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City | HOLLYWOOD
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State | FL
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Zip | 33020-5424
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Country | US
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Telephone | 954-342-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 540 WEST AVE #414
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City | MIAMI BEACH
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State | FL
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Zip | 33139-6768
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Country | US
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Telephone | 305-205-8846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME77576
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License Number State | FL
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