Provider Demographics
NPI:1881632479
Name:ALBARRAN, CARLA JOY (DO)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:JOY
Last Name:ALBARRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:CARLA
Other - Middle Name:JOY
Other - Last Name:CRESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:4683 VAN DYKE RD STE 101B
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-4880
Mailing Address - Country:US
Mailing Address - Phone:813-968-7171
Mailing Address - Fax:813-443-8167
Practice Address - Street 1:4683 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-4880
Practice Address - Country:US
Practice Address - Phone:813-968-7171
Practice Address - Fax:813-443-8167
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9763208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275890300Medicaid