Provider Demographics
NPI:1871721118
Name:CALERO, AURELIA THIBONNIER (MD)
Entity type:Individual
Prefix:
First Name:AURELIA
Middle Name:THIBONNIER
Last Name:CALERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-974-2201
Mailing Address - Fax:813-974-4325
Practice Address - Street 1:2700 HEALING WAY
Practice Address - Street 2:SUITE 300
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5453
Practice Address - Country:US
Practice Address - Phone:813-259-0929
Practice Address - Fax:813-259-4280
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1192882086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012828400Medicaid
FL14W10OtherBLUE CROSS BLUE SHIELD
FL012828400Medicaid