MEDICARE: DR. CHRISTIANO C CALDEIRA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME0092573	FL
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35075556C	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396748596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTIANO C CALDEIRA M.D.

Provider Business Mailing Address
First Line	:	1345 W BAY DR STE 301
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33770-2264
Country	:	US
Telephone Number	:	727-587-7111
Fax Number	:	727-518-0166

Provider Business Practice Location Address
First Line	:	1345 W BAY DR STE 301
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33770-2264
Country	:	US
Telephone Number	:	727-587-7111
Fax Number	:	727-518-0166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/09/2022

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