Provider Demographics
NPI:1518450378
Name:CALERO, ALLYSA BARBIE (OT)
Entity Type:Individual
Prefix:
First Name:ALLYSA
Middle Name:BARBIE
Last Name:CALERO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 CATALONIA AVE STE 804
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6727
Mailing Address - Country:US
Mailing Address - Phone:305-774-1788
Mailing Address - Fax:305-774-1789
Practice Address - Street 1:250 CATALONIA AVE STE 804
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6727
Practice Address - Country:US
Practice Address - Phone:305-774-1788
Practice Address - Fax:305-774-1789
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist