| Organization Name: | SOUTH FLORIDA SPORTS MEDICINE & PRIMARY CARE, P.A. |
| NPI Number: | 1053726612 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALDO A CALONJE (PHYSICIAN / OWNER) |
| Mailing Address: | 7401 N University Dr Suite 206 Tamarac |
| State: | FL US |
| Postal Code: | 333212979 |
| Phone Number: | 9547182230 |
| Fax Number: | 9547182232 |
| NPI Enumeration Date: | 06/23/2014 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ME95141 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |