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Individual

MR. JUAN CARABALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1021 S WASHINGTON AVE, TITUSVILLE, FL 32780-8404
(321) 567-7500
Mailing address
4368 PONDAPPLE DR, TITUSVILLE, FL 32796-1433
(321) 759-3616

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PS26148
FL

Other

Enumeration date
05/09/2018
Last updated
05/09/2018
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