Provider Demographics
NPI:1063729374
Name:CALDERIN, RAUL
Entity type:Individual
Prefix:
First Name:RAUL
Middle Name:
Last Name:CALDERIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 NW 57TH CT STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3292
Mailing Address - Country:US
Mailing Address - Phone:305-649-8100
Mailing Address - Fax:
Practice Address - Street 1:7800 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2128
Practice Address - Country:US
Practice Address - Phone:954-670-1170
Practice Address - Fax:954-670-1171
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115112207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty