Provider Demographics
NPI:1558049510
Name:CALVEIRO, SANDRA MILENA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MILENA
Last Name:CALVEIRO
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 1:20 NW 203RD TER APT C7
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2630
Mailing Address - Country:US
Mailing Address - Phone:786-760-0055
Mailing Address - Fax:
Practice Address - Street 1:20 NW 203RD TER APT C7
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2630
Practice Address - Country:US
Practice Address - Phone:786-760-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-282402106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician