Healthcare Provider Details

I. General information

NPI: 1093252181
Provider Name (Legal Business Name): YANEISY CALDERON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NE 36TH LN
CAPE CORAL FL
33909-6427
US

IV. Provider business mailing address

1500 NE 36TH LN
CAPE CORAL FL
33909-6427
US

V. Phone/Fax

Practice location:
  • Phone: 786-317-7131
  • Fax:
Mailing address:
  • Phone: 786-317-7131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT2012681
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: