Provider Demographics
NPI:1265513493
Name:CALDERIN, MAYRA M (MD)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:M
Last Name:CALDERIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:LA CUMBRE 130 MONTEBELLO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7109
Mailing Address - Country:US
Mailing Address - Phone:787-405-5862
Mailing Address - Fax:787-790-0575
Practice Address - Street 1:650 CALLE LLOVERAS STE 101
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2110
Practice Address - Country:US
Practice Address - Phone:787-405-5862
Practice Address - Fax:787-790-0575
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR94422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE63400Medicare UPIN