Provider Demographics
NPI:1790426260
Name:MARRERO-CALDERO, DANELY (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:DANELY
Middle Name:
Last Name:MARRERO-CALDERO
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CALLE GANDARA
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-2057
Mailing Address - Country:US
Mailing Address - Phone:787-634-8029
Mailing Address - Fax:
Practice Address - Street 1:12 CALLE GANDARA
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-2057
Practice Address - Country:US
Practice Address - Phone:787-634-8029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8552183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8552Medicaid