Healthcare Provider Details

I. General information

NPI: 1023987476
Provider Name (Legal Business Name): LUIS MANUEL CALERO GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4793 N CONGRESS AVE STE 203
BOYNTON BEACH FL
33426-7937
US

IV. Provider business mailing address

2238 SHIMMERY LN
LANTANA FL
33462-6002
US

V. Phone/Fax

Practice location:
  • Phone: 561-429-3863
  • Fax: 561-448-6063
Mailing address:
  • Phone: 561-846-0851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-416383
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: