Provider Demographics
NPI:1659663227
Name:CALDERIN REMEDIO, RICHAR (MA)
Entity Type:Individual
Prefix:
First Name:RICHAR
Middle Name:
Last Name:CALDERIN REMEDIO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7483 SW 24TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1459
Mailing Address - Country:US
Mailing Address - Phone:305-267-3362
Mailing Address - Fax:305-267-3363
Practice Address - Street 1:7483 SW 24TH ST STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1459
Practice Address - Country:US
Practice Address - Phone:305-267-3362
Practice Address - Fax:305-267-3363
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 62182225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA 62182OtherMASSAGE THERAPIST