Organization
RAUL E. CARBALLOSA AND ASSOCIATESMDSPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN PARSON (BILIING SECRETARY)
(941) 639-4933
Entity
Organization
Contact information
Practice address
310 DUPONT ST, PUNTA GORDA, FL 33950-3810
(941) 639-4933
Mailing address
PO BOX 510730, PUNTA GORDA, FL 33951-0730
(941) 639-4933
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0047929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11726
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/22/2006
Last updated
01/14/2008
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