Organization Active NPI

Lita R. Calagua MD PA

  • Neurology Physician
  • Davie, FL
National Provider Identifier
1922277375
Registry record updated Oct 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME78150 Issued in FL
Legal business name
LITA R. CALAGUA MD PA
Practice address
10650 W State Road 84 Ste 211
Davie, FL 33324-4235
Phone
(954) 476-8126
Fax
(954) 449-8940
NPI assigned
Feb 29, 2008
Last updated
Oct 9, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2017

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

Authorized official

Name
Lita R Calagua, M.D.
Title
Owner
Phone
(954) 476-8126

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME78150 FL Primary

Addresses

Primary practice location

10650 W State Road 84 Ste 211
Davie, FL 33324-4235

Mailing address

10650 W State Road 84 Ste 211
Davie, FL 33324-4235
Phone (954) 476-8126

Other identifiers 1

IdentifierTypeStateIssuer
263966100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000734 FL Part B Supplier - Clinic/Group Practice 0840365797 Receives reassigned benefits from 1 practitioner
Practice locations: Davie, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1922277375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10650 W STATE ROAD 84 STE 211",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244235",
            "telephone_number": "954-476-8126",
            "fax_number": "954-449-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 W STATE ROAD 84 STE 211",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244235",
            "telephone_number": "954-476-8126",
            "fax_number": "954-449-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITA R. CALAGUA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "CALAGUA",
        "authorized_official_first_name": "LITA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-476-8126",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME78150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263966100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.