Provider Demographics
NPI:1871734467
Name:ENRIQUE A CALLE M D PA
Entity type:Organization
Organization Name:ENRIQUE A CALLE M D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-616-9545
Mailing Address - Street 1:8519 SAINT MARINO BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-8765
Mailing Address - Country:US
Mailing Address - Phone:407-616-9545
Mailing Address - Fax:407-996-3478
Practice Address - Street 1:8519 SAINT MARINO BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-8765
Practice Address - Country:US
Practice Address - Phone:407-616-9545
Practice Address - Fax:407-996-3478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49797207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty