Individual
FERNANDO A CARBALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8380 RIVERWALK PARK BLVD STE 310, FORT MYERS, FL 33919-8758
(239) 291-3602
(239) 291-3603
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
53132
MN
207RG0100X
Gastroenterology Physician
Primary
ME137751
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32471200
—
WI
01
—
P00742968
RR MEDICARE
WI
Enumeration date
04/05/2006
Last updated
10/30/2023
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