Provider Demographics
NPI:1962433359
Name:ALEXIS-CALIXTE, NANCY (DPM)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:ALEXIS-CALIXTE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 MIRAMAR PKWY
Mailing Address - Street 2:SUITE117
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4100
Mailing Address - Country:US
Mailing Address - Phone:954-442-6100
Mailing Address - Fax:954-442-6202
Practice Address - Street 1:8910 MIRAMAR PKWY
Practice Address - Street 2:SUITE 117
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4100
Practice Address - Country:US
Practice Address - Phone:954-442-6100
Practice Address - Fax:954-442-6202
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3243213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340589300Medicaid
FL340589300Medicaid
FL65940ZMedicare PIN
FL5747630001Medicare NSC