| South Florida Sports Medicine & Primary Care, P.a. | |
|
7310 W Mcnab Rd Ste 107 Tamarac FL 33321-5327 | |
| (954) 718-2230 | |
| (954) 718-2232 |
| Full Name | South Florida Sports Medicine & Primary Care, P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 7310 W Mcnab Rd Ste 107, Tamarac, Florida |
| Authorized Official Name and Position | Ronaldo A Calonje (PHYSICIAN / OWNER) |
| Authorized Official Contact | 9547182230 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Florida Sports Medicine & Primary Care, P.a. 7310 W Mcnab Rd Ste 107 Tamarac FL 33321-5327 Ph: (954) 718-2230 | South Florida Sports Medicine & Primary Care, P.a. 7310 W Mcnab Rd Ste 107 Tamarac FL 33321-5327 Ph: (954) 718-2230 |
| NPI Number | 1053726612 |
|---|---|
| Provider Enumeration Date | 06/23/2014 |
| Last Update Date | 01/13/2022 |
| Medicare PECOS PAC ID | 9234456930 |
|---|---|
| Medicare Enrollment ID | O20150317001995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053726612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME95141 (Florida) | Primary |
| Provider Name | Ronaldo Calonje |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104977362 PECOS PAC ID: 5395755391 Enrollment ID: I20060504000178 |
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