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General NPI Number Information
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NPI Number | 1992816730
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Entity Type | Individual
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Provider Name | FERNANDO CALDERON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1549 CALLE ALDA
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City | SAN JUAN
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State | PR
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Zip | 00926-2709
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Country | US
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Telephone | 787-622-9797
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Fax | 787-622-9888
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Provider Business Mailing Address
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Address Line | 1450 AVE ASHFORD APT 7A
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City | SAN JUAN
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State | PR
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Zip | 00907-1537
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Country | US
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Telephone | 787-721-6557
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Fax | 787-765-0691
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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 | 2084P0005X
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Taxonomy Name | Neurodevelopmental Disabilities Physician
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License Number | 11876
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License Number State | PR
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