Healthcare Provider Details

I. General information

NPI: 1245619899
Provider Name (Legal Business Name): LEDYS CALLEJA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18901 SW 106TH AVE STE 229-230
CUTLER BAY FL
33157-7661
US

IV. Provider business mailing address

18901 SW 106TH AVE STE 229-230
CUTLER BAY FL
33157-7661
US

V. Phone/Fax

Practice location:
  • Phone: 786-808-6575
  • Fax: 786-808-6576
Mailing address:
  • Phone: 786-808-6575
  • Fax: 786-808-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCBHCMS0100884
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number0100884
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberCBHCMS0100884
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: