MEDICARE: LITA R. CALAGUA MD PA

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	2084N0400X	Neurology Physician	ME78150	FL

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	:	1922277375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITA R. CALAGUA MD PA

Provider Business Mailing Address
First Line	:	10650 W STATE ROAD 84 STE 211
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-4235
Country	:	US
Telephone Number	:	954-476-8126
Fax Number	:	954-449-8940

Provider Business Practice Location Address
First Line	:	10650 W STATE ROAD 84 STE 211
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33324-4235
Country	:	US
Telephone Number	:	954-476-8126
Fax Number	:	954-449-8940

Authorized Official
Title or Position	:	OWNER
Name	:	LITA R CALAGUA
Credential	:	M.D.
Telephone Number	:	954-476-8126

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	10/09/2017

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