Provider Demographics
NPI:1114253242
Name:CARABALLO, DAVID ORLANDO (PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ORLANDO
Last Name:CARABALLO
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:836 E. 65TH STREET
Mailing Address - Street 2:SUITE 22
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-819-7878
Mailing Address - Fax:912-819-3320
Practice Address - Street 1:109 S. GREEN STREET
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936
Practice Address - Country:US
Practice Address - Phone:843-726-6773
Practice Address - Fax:843-726-6778
Is Sole Proprietor?:No
Enumeration Date:2009-10-24
Last Update Date:2021-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
363AM0700X
SC1806363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical