Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 18202 | PR |
NPI | 1104050640 |
---|---|
Provider Name | Barbara Calderon-Vizcarrondo |
First Address | Tampa, FL 33604-2540 |
Second Address | Tampa, FL 33604-2540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2009 |
Last Update Date | 03/03/2014 |