Provider Demographics
NPI:1104977362
Name:CALONJE, RONALDO A (MD)
Entity type:Individual
Prefix:DR
First Name:RONALDO
Middle Name:A
Last Name:CALONJE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7401 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2979
Mailing Address - Country:US
Mailing Address - Phone:954-718-2230
Mailing Address - Fax:
Practice Address - Street 1:7401 N UNIVERSITY DR
Practice Address - Street 2:SUITE 206
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2979
Practice Address - Country:US
Practice Address - Phone:954-718-2230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95141207QS0010X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME95141OtherFLORIDA MEDICAL LICENSE
FLME95141OtherFLORIDA MEDICAL LICENSE