Provider Demographics
NPI:1669959797
Name:CALLEJA, MARIA ALEJANDRA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ALEJANDRA
Last Name:CALLEJA
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 1:11261 SW 156TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-4397
Mailing Address - Country:US
Mailing Address - Phone:786-226-7417
Mailing Address - Fax:
Practice Address - Street 1:11261 SW 156TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-4397
Practice Address - Country:US
Practice Address - Phone:786-226-7417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-21
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9337939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily