Provider Demographics
NPI:1649041658
Name:NEGRIN CALDERON, MARIANELA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:MARIANELA
Middle Name:DE LA CARIDAD
Last Name:NEGRIN CALDERON
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 1:517 SW 94TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-2145
Mailing Address - Country:US
Mailing Address - Phone:305-219-8452
Mailing Address - Fax:
Practice Address - Street 1:517 SW 94TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-2145
Practice Address - Country:US
Practice Address - Phone:305-219-8452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily