Provider Demographics
NPI:1952689549
Name:CARABALLO, MARIA D
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:D
Last Name:CARABALLO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:CARABALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FACTURADORA
Mailing Address - Street 1:300B CALLE 36
Mailing Address - Street 2:PARCELA FALU
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-3127
Mailing Address - Country:US
Mailing Address - Phone:787-674-4742
Mailing Address - Fax:
Practice Address - Street 1:300B CALLE 36
Practice Address - Street 2:PARCELA FALU
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00924-3127
Practice Address - Country:US
Practice Address - Phone:787-674-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other