Provider Demographics
NPI:1699500892
Name:CALDERON SALOM, AMPARO JUDITH (APRN)
Entity type:Individual
Prefix:MRS
First Name:AMPARO
Middle Name:JUDITH
Last Name:CALDERON SALOM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:AMPARO
Other - Middle Name:JUDITH
Other - Last Name:CALDERON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 878
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33836-0878
Mailing Address - Country:US
Mailing Address - Phone:689-223-3898
Mailing Address - Fax:689-223-3898
Practice Address - Street 1:7824 LAKE UNDERHILL RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8201
Practice Address - Country:US
Practice Address - Phone:407-281-0470
Practice Address - Fax:407-273-1848
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty