Organization Active NPI

Calzada Primary Care, PA

  • Primary Care Clinic/Center
  • Pembroke Pines, FL
National Provider Identifier
1225301013
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CALZADA PRIMARY CARE, PA
Practice address
2301 N University Dr Ste 108
Pembroke Pines, FL 33024-3617
Phone
(954) 987-4900
Fax
(954) 987-4922
NPI assigned
Feb 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Pablo J Calzada, D.O.NPI 1528007887
Title
President
Phone
(954) 987-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2301 N University Dr Ste 108
Pembroke Pines, FL 33024-3617

Mailing address

2301 N University Dr Ste 108
Pembroke Pines, FL 33024-3617
Phone (954) 987-4900

Other identifiers 1

IdentifierTypeStateIssuer
104374600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130206000196 FL Part B Supplier - Clinic/Group Practice 8022262765 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke Pines, FL

National Provider Directory

National Provider Directory

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727395200000",
    "number": "1225301013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR STE 108",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-987-4900",
            "fax_number": "954-987-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N UNIVERSITY DR STE 108",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243617",
            "telephone_number": "954-987-4900",
            "fax_number": "954-987-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALZADA PRIMARY CARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A",
        "authorized_official_last_name": "CALZADA",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-987-4900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104374600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.