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General NPI Number Information
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NPI Number | 1770004806
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Entity Type | Individual
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Provider Name | BARBARA MADAY CALDERON IZQUIERDO MD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1563 LAND O LAKES BLVD
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City | LUTZ
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State | FL
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Zip | 33549-2930
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Country | US
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Telephone | 813-949-4224
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Fax | 866-372-2717
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Provider Business Mailing Address
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Address Line | 1711 W ATKINSON ST
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City | TAMPA
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State | FL
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Zip | 33604-1015
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Country | US
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Telephone | 305-394-2471
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1127
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License Number State | FL
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