Provider Demographics
NPI:1205694502
Name:CALERO TREATMENT SERVICES LLC
Entity type:Organization
Organization Name:CALERO TREATMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRNALIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ CALERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-981-7671
Mailing Address - Street 1:CALLE UCAR 1019
Mailing Address - Street 2:URB. HACIENDA BORINQUEN
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-981-7671
Mailing Address - Fax:
Practice Address - Street 1:URB. MARIOLGA
Practice Address - Street 2:S-2 AVE. LUIS MUNOZ MARIN
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-981-7671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty