Provider Demographics
NPI:1487007142
Name:CALERO NEIRA, MARITZA
Entity type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:CALERO NEIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19715 SW 114TH AVE APT 157
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1006
Mailing Address - Country:US
Mailing Address - Phone:305-764-6343
Mailing Address - Fax:
Practice Address - Street 1:175 FONTAINEBLEAU BLVD STE 2D1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-7013
Practice Address - Country:US
Practice Address - Phone:786-397-4222
Practice Address - Fax:305-228-7009
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst