Provider Demographics
NPI:1881803427
Name:CALVO, DANIEL (OTD OTRL)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:CALVO
Suffix:
Gender:M
Credentials:OTD OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 WINDLEY DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-0047
Mailing Address - Country:US
Mailing Address - Phone:863-224-6493
Mailing Address - Fax:
Practice Address - Street 1:347 WINDLEY DR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-0047
Practice Address - Country:US
Practice Address - Phone:863-224-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10756225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty