Healthcare Provider Details

I. General information

NPI: 1821291907
Provider Name (Legal Business Name): SHEYLA YADIRA CALDERON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 11/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 CALLE WASHINGTON OFFICE 303
SAN JUAN PR
00907-1510
US

IV. Provider business mailing address

29 CALLE WASHINGTON ASHFORD MEDICAL CENTER OFFICE 303
SAN JUAN PR
00907
US

V. Phone/Fax

Practice location:
  • Phone: 787-721-2250
  • Fax: 787-721-2249
Mailing address:
  • Phone: 787-721-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number17939
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: