Provider Demographics
NPI:1003274002
Name:DELGADO CARABALLO, MARIA GABRIELA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:GABRIELA
Last Name:DELGADO CARABALLO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:GABRIELA
Other - Last Name:CARABALLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 100415
Mailing Address - Street 2:1395 CENTER DR., RM. D9-6
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0415
Mailing Address - Country:US
Mailing Address - Phone:352-273-5850
Mailing Address - Fax:352-846-1643
Practice Address - Street 1:1395 CENTER DR RM D9-6
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0415
Practice Address - Country:US
Practice Address - Phone:352-273-5850
Practice Address - Fax:352-846-1643
Is Sole Proprietor?:No
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist