Provider Demographics
NPI:1407931918
Name:CF PEDIATRIC CARE CENTER P.S.C.
Entity Type:Organization
Organization Name:CF PEDIATRIC CARE CENTER P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NILKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-617-2072
Mailing Address - Street 1:AVENTURA 7802
Mailing Address - Street 2:ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-617-2072
Mailing Address - Fax:
Practice Address - Street 1:CALLE CAZUL #52
Practice Address - Street 2:URB. VALENCIA UNO
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-617-2072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13482174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty