Provider Demographics
NPI:1275619157
Name:CORDERO-CALERO, SAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:
Last Name:CORDERO-CALERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAUL
Other - Middle Name:
Other - Last Name:CORDERO CALERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:P. O. BOX 123
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0123
Mailing Address - Country:US
Mailing Address - Phone:787-854-3131
Mailing Address - Fax:787-854-3235
Practice Address - Street 1:C/MARGINAL ELLIOT VELEZ , ESQ. HERNANDEZ URB. ATENAS
Practice Address - Street 2:CENTRO RADIOLOGICO Y SONOGRAFICO DE MANATI
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-0000
Practice Address - Country:US
Practice Address - Phone:787-854-3131
Practice Address - Fax:787-854-3235
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13,0222085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13,022OtherPUERTO RICO MEDICAL LICENCE
PRDM 13121-9OtherAMSSCA
PRDM 13121-9OtherAMSSCA
PR0020381Medicare ID - Type UnspecifiedNEURORADIOLOGO
PRDM 13121-9OtherAMSSCA
PR0085360BMedicare PIN