Provider Demographics
NPI:1689442162
Name:CALZADILLA, ANLIET M
Entity Type:Individual
Prefix:
First Name:ANLIET
Middle Name:M
Last Name:CALZADILLA
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 1:119 NE 4TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33909-2518
Mailing Address - Country:US
Mailing Address - Phone:239-710-3731
Mailing Address - Fax:
Practice Address - Street 1:119 NE 4TH CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2518
Practice Address - Country:US
Practice Address - Phone:239-710-3731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-14
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician