=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255610275
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAILEN CALERO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/08/2011
-----------------------------------------------------
Last Update Date | 02/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 326 SW 12TH AVE # A
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33130-2012
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-545-8913
-----------------------------------------------------
Fax | 305-642-7733
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5201 SW 116TH AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33165-6825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-327-4886
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11024719
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------