Individual
MICHAEL C CAVALLARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 PHILLIPS RD, TALLAHASSEE, FL 32308-5304
(850) 878-4127
(850) 878-0337
Mailing address
PO BOX 1678, TALLAHASSEE, FL 32302-1678
(850) 878-4102
(850) 942-4155
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
ME54263
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME54263
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000841057A
—
GA
05
—
000841057C
—
GA
05
—
000841057D
—
GA
05
—
255299000
—
FL
01
—
E1603
BCBS
FL
Enumeration date
05/18/2006
Last updated
07/06/2015
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