Healthcare Provider Details

I. General information

NPI: 1932026267
Provider Name (Legal Business Name): CECILLE MARIE BARRIOS-CALDERIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 US-17
FLEMING ISLAND FL
32003
US

IV. Provider business mailing address

49 SUNBERRY WAY
SAINT AUGUSTINE FL
32092
US

V. Phone/Fax

Practice location:
  • Phone: 305-409-7206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11047362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: