Provider Demographics
NPI:1992795900
Name:CALONGE, RICARDO O (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:O
Last Name:CALONGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3661 S MIAMI AVE
Mailing Address - Street 2:SUITE #401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4236
Mailing Address - Country:US
Mailing Address - Phone:305-856-9771
Mailing Address - Fax:305-728-0536
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:SUITE #401
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-856-9771
Practice Address - Fax:305-728-0536
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 89807207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI14892Medicare UPIN
FLU3106YMedicare PIN
FLK5567Medicare PIN