Provider Demographics
NPI:1568187227
Name:CANDELARIA SERVICES INC
Entity Type:Organization
Organization Name:CANDELARIA SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:IBELIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CALVI EXPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-273-5559
Mailing Address - Street 1:25646 SW 125TH PL
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5899
Mailing Address - Country:US
Mailing Address - Phone:786-273-5559
Mailing Address - Fax:
Practice Address - Street 1:25646 SW 125TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5899
Practice Address - Country:US
Practice Address - Phone:786-273-5559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty