Provider Demographics
NPI:1851996722
Name:CALAFORRA, ERIC PELEGRIN (LMHC, RN)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:PELEGRIN
Last Name:CALAFORRA
Suffix:
Gender:M
Credentials:LMHC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W 59TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2307
Mailing Address - Country:US
Mailing Address - Phone:786-488-3235
Mailing Address - Fax:
Practice Address - Street 1:1021 W 59TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2307
Practice Address - Country:US
Practice Address - Phone:786-488-3235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9515994163W00000X
FLMH16622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse