Individual
JORGE CARBALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8710 SW 41ST TER, MIAMI, FL 33165-5437
(786) 416-1663
Mailing address
8710 SW 41ST TER, MIAMI, FL 33165-5437
(786) 416-1663
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
9351651
FL
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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