Provider Demographics
NPI:1063759645
Name:BRYAN CALVO DPM PA
Entity type:Organization
Organization Name:BRYAN CALVO DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-595-7808
Mailing Address - Street 1:7190 SW 87TH AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2507
Mailing Address - Country:US
Mailing Address - Phone:305-595-7808
Mailing Address - Fax:305-595-7809
Practice Address - Street 1:7190 SW 87TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2507
Practice Address - Country:US
Practice Address - Phone:305-595-7808
Practice Address - Fax:305-595-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3401213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty