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General NPI Number Information
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NPI Number | 1689066326
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Entity Type | Organization
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Legal Business Name | RICARDO O. CALONGE, MD PA
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 3661 S MIAMI AVE SUITE 401
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City | MIAMI
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State | FL
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Zip | 33133-4236
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Country | US
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Telephone | 305-856-9771
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Fax | 305-728-0536
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Provider Business Mailing Address
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Address Line | 3661 S MIAMI AVE SUITE 401
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City | MIAMI
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State | FL
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Zip | 33133-4236
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Country | US
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Telephone | 305-856-9771
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Fax | 305-728-0536
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RICARDO O CALONGE
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Credential | M.D.
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Telephone | 305-856-9771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME89807
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License Number State | FL
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