Provider Demographics
NPI:1427190289
Name:CARRALERO, RITA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:MARIA
Last Name:CARRALERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8756 SW 72ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3512
Mailing Address - Country:US
Mailing Address - Phone:786-598-7004
Mailing Address - Fax:786-598-7005
Practice Address - Street 1:8756 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3512
Practice Address - Country:US
Practice Address - Phone:786-598-7004
Practice Address - Fax:786-598-7005
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113592400Medicaid
FL45084Medicare ID - Type Unspecified
FLG61777Medicare UPIN