Healthcare Provider Details

I. General information

NPI: 1891226494
Provider Name (Legal Business Name): GISELLE DE LA CARIDAD CALDERON GALVEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5984 SW 162ND PL
MIAMI FL
33193-5672
US

IV. Provider business mailing address

5984 SW 162ND PL
MIAMI FL
33193-5672
US

V. Phone/Fax

Practice location:
  • Phone: 786-306-7525
  • Fax:
Mailing address:
  • Phone: 786-306-7525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-50880
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-48070
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: