Provider Demographics
NPI:1588629281
Name:CALERO, FERNANDO M SR (MD)
Entity Type:Individual
Prefix:MR
First Name:FERNANDO
Middle Name:M
Last Name:CALERO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605
Mailing Address - Country:US
Mailing Address - Phone:787-891-5900
Mailing Address - Fax:787-891-5900
Practice Address - Street 1:AVE SAN CARLOS #16
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-5900
Practice Address - Fax:787-891-5900
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2996207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
93720Medicare ID - Type Unspecified
C83793Medicare UPIN