Individual
MRS. MELISSA RICHARDSON CARABALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3028 4TH ST STE A&B, MARIANNA, FL 32446-2127
(850) 718-2886
(850) 633-5908
Mailing address
4250 HOSPITAL DR, MARIANNA, FL 32446-1917
(850) 718-2886
(850) 718-2891
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS 12572
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012137600
—
FL
Enumeration date
06/23/2011
Last updated
03/03/2021
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