Provider Demographics
NPI:1053395715
Name:CALDWELL, DYLAN M (MD)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:M
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3581 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-2707
Mailing Address - Country:US
Mailing Address - Phone:239-537-2318
Mailing Address - Fax:239-842-1213
Practice Address - Street 1:200 AVIATION DR N STE 9
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-3501
Practice Address - Country:US
Practice Address - Phone:239-206-8885
Practice Address - Fax:239-842-1213
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80596207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261410300Medicaid
FL58881OtherBCBS
FL58881OtherBCBS
G83502Medicare UPIN
FL58881ZMedicare ID - Type Unspecified