Provider Demographics
NPI:1235620642
Name:CALDERON-FLORES, MERCEDES M
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:M
Last Name:CALDERON-FLORES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10242 NW 47TH ST STE 22&23
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7903
Mailing Address - Country:US
Mailing Address - Phone:954-533-5353
Mailing Address - Fax:954-827-2763
Practice Address - Street 1:10242 NW 47TH ST STE 22&23
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7903
Practice Address - Country:US
Practice Address - Phone:954-533-5353
Practice Address - Fax:954-827-2763
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101663300Medicaid
FL021689300Medicaid