Healthcare Provider Details

I. General information

NPI: 1518928597
Provider Name (Legal Business Name): MILDRED CALERO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF CENTRAL CARIBE
BAYAMON PR
00960-6032
US

IV. Provider business mailing address

690 CESAR GONZALEZ PARQUE DE LAS FUENTAS, #1707
SAN JUAN PR
00918
US

V. Phone/Fax

Practice location:
  • Phone: 787-798-3001
  • Fax:
Mailing address:
  • Phone: 787-765-8795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4733
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: