Nellyann Ayala Caldero, BA, PMB, CFM, RN

Individual provider Active NPI Mastectomy Fitter · Caguas, PR

NPI 1548090152 · NPPES record last updated Feb 12, 2025

Key facts

NPI
1548090152
Entity type
Individual (NPI type 1)
Primary specialty
Mastectomy Fitter 224900000X
License
CFM03114 (VA)
Practice address
Ave. Degetau Bonneville Heights #4 Calle Las Piedras W1
Caguas, PR 00727
Phone
(787) 526-5557
NPI assigned
Aug 7, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Arts, Registered Nurse

State licenses

LicenseStateTypeSpecialty
CFM03114VAMDMastectomy Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Miracle of Hope Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mastectomy Fitter
Group: 193400000X SINGLE SPECIALTY GROUP
224900000X CFM03114 VA Yes

Addresses

Primary practice location

Ave. Degetau Bonneville Heights #4 Calle Las Piedras W1
Caguas, PR 00727

Mailing address

Parque del Monte Calle Caguax Ee-30
Caguas, PR 00727
Phone (787) 526-5557

Other providers in Caguas, PR

All providers in Caguas, PR · Mastectomy Fitter in Puerto Rico

Sources for this page

Verify at the official NPI Registry.