Provider Demographics
NPI:1336437110
Name:CALIOLIO, JEFFREY CLAUDE LUNA (MSN)
Entity type:Individual
Prefix:
First Name:JEFFREY CLAUDE
Middle Name:LUNA
Last Name:CALIOLIO
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4970
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32802-4970
Mailing Address - Country:US
Mailing Address - Phone:407-836-3314
Mailing Address - Fax:
Practice Address - Street 1:2450 33RD ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-8726
Practice Address - Country:US
Practice Address - Phone:407-836-3314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9215385363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health