Provider Demographics
NPI:1831968700
Name:CALERO, MAIDELYS
Entity type:Individual
Prefix:
First Name:MAIDELYS
Middle Name:
Last Name:CALERO
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 1:5707 EVERGLADES BLVD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3110
Mailing Address - Country:US
Mailing Address - Phone:239-600-8047
Mailing Address - Fax:
Practice Address - Street 1:5707 EVERGLADES BLVD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-3110
Practice Address - Country:US
Practice Address - Phone:239-600-8047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician