Healthcare Provider Details

I. General information

NPI: 1538044268
Provider Name (Legal Business Name): WILMARIE ROSA CALZADA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO ASIA, 1503 C. PROF. AUGUSTO RODRIGUEZ SUITE 600
SAN JUAN PR
00909
US

IV. Provider business mailing address

URB. VISTAS DE LUQUILLO D 64 CALLE V2
LUQUILLO PR
00773-2709
US

V. Phone/Fax

Practice location:
  • Phone: 787-296-8888
  • Fax:
Mailing address:
  • Phone: 787-516-9255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16887
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: