=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578489506
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERIKA CALDERON LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2026
-----------------------------------------------------
Last Update Date | 06/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5210 ST LUCIA DR
-----------------------------------------------------
City | LAKELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33812-4088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-823-6302
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5210 ST LUCIA DR
-----------------------------------------------------
City | LAKELAND
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33812-4088
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-823-6302
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ CLINICAL DIRECTOR
-----------------------------------------------------
Name | MISS ERIKA CALDERON
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 239-823-6302
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------