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General NPI Number Information
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NPI Number | 1639596968
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Entity Type | Individual
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Provider Name | MICHAEL CALDERIN M.A.
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Gender | Male
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 15800 PINES BLVD STE 310
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1212
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Country | US
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Telephone | 954-990-0918
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Fax |
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Provider Business Mailing Address
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Address Line | 18459 PINES BLVD #281
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1400
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Country | US
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Telephone | 954-990-0918
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CMHP#50161
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP#2288
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License Number State | FL
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