Individual
MARLO CALDEVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4710 N HABANA AVE STE 307, TAMPA, FL 33614-7151
(813) 874-2000
Mailing address
4710 N HABANA AVE STE 307, TAMPA, FL 33614-7151
(813) 874-2000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9436825
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
11017889
FL
Other
Enumeration date
11/07/2020
Last updated
09/20/2022
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