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Lyannette Calderon Elo

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

333 N Santa Rosa, San Antonio, TX 78207-3108

PECOS Enrollment

This provider is enrolled in PECOS as LYANNETTE ELO.

Based on the most recent information from CMS, provider Lyannette Calderon Elo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1225501885
Provider Type
Individual
Full Name
Elo, Lyannette Calderon
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
1/7/2019
Last Updated
7/29/2025

Contact Information

Practice Location

333 N Santa Rosa, San Antonio, TX 78207-3108

(210) 704-2642

Unlisted Fax

Mailing Location

315 N San Saba Ste 1135, San Antonio, TX 78207-3255

(210) 704-3030

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 1012843 Texas
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN11000240 Florida
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 11000240 Florida

Lyannette Calderon Elo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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