Provider Demographics
NPI:1437374758
Name:CALERO-RECIO, FERNANDO M (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:M
Last Name:CALERO-RECIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FERNANDO
Other - Middle Name:M
Other - Last Name:CALERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:68 CALLE SANTA CRUZ STE 103
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7038
Mailing Address - Country:US
Mailing Address - Phone:787-620-4747
Mailing Address - Fax:787-787-3035
Practice Address - Street 1:68 CALLE SANTA CRUZ STE 103
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7038
Practice Address - Country:US
Practice Address - Phone:787-620-4747
Practice Address - Fax:787-787-3035
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR117612086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC 83793Medicare UPIN