Provider Demographics
NPI:1194406462
Name:HUGO F CALERO PA
Entity type:Organization
Organization Name:HUGO F CALERO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:FARDSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-600-6566
Mailing Address - Street 1:104 NW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7008
Mailing Address - Country:US
Mailing Address - Phone:954-866-1995
Mailing Address - Fax:
Practice Address - Street 1:6896 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5045
Practice Address - Country:US
Practice Address - Phone:954-866-1995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty