Provider Demographics
NPI:1366109860
Name:CALLEJA, KATIA (APRN)
Entity type:Individual
Prefix:MS
First Name:KATIA
Middle Name:
Last Name:CALLEJA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10794 N KENDALL DR APT B22
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1419
Mailing Address - Country:US
Mailing Address - Phone:786-234-6571
Mailing Address - Fax:
Practice Address - Street 1:10691 N KENDALL DR STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1596
Practice Address - Country:US
Practice Address - Phone:305-878-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-19
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016670363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty