Individual
MIKEL CALDERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2307 W BROWARD BLVD, STE 200, FORT LAUDERDALE, FL 33312-1417
(954) 792-1010
(954) 792-1199
Mailing address
2307 W BROWARD BLVD, STE 200, FORT LAUDERDALE, FL 33312-1417
(954) 792-1010
(954) 792-1199
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
PA9109411
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BO758W
PTAN
CA
Enumeration date
12/23/2008
Last updated
03/17/2018
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