Provider Demographics
NPI:1457869364
Name:CALDERIN, PAUL (LPN, AA)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:CALDERIN
Suffix:
Gender:M
Credentials:LPN, AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N FEDERAL HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1618
Mailing Address - Country:US
Mailing Address - Phone:305-985-9770
Mailing Address - Fax:754-206-3730
Practice Address - Street 1:2500 N FEDERAL HWY STE 103
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1618
Practice Address - Country:US
Practice Address - Phone:305-985-9770
Practice Address - Fax:754-206-3730
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1227991164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse