Individual
NISA NYREE CARABALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
245 38TH ST S, ST PETERSBURG, FL 33711-1222
(727) 512-8465
Mailing address
245 38TH ST S, ST PETERSBURG, FL 33711-1222
(727) 512-8465
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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