MEDICARE: HUGO F CALERO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194406462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUGO F CALERO PA

Provider Business Mailing Address
First Line	:	104 NW 100TH AVE
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-7008
Country	:	US
Telephone Number	:	954-866-1995
Fax Number	:

Provider Business Practice Location Address
First Line	:	6896 W ATLANTIC BLVD
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-5045
Country	:	US
Telephone Number	:	954-866-1995
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMIR FARDSHI
Credential	:
Telephone Number	:	310-600-6566

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	02/13/2026

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Directions to “HUGO F CALERO PA ” Practice Location

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