Individual
DR. RAUL ENRIQUE CARBALLOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9970 CENTRAL PARK BLVD N, SUITE 207, BOCA RATON, FL 33428-2231
(561) 482-1027
(561) 482-1028
Mailing address
9960 NW 116TH WAY, SUITE 13, MEDLEY, FL 33178-1167
(786) 924-1311
(786) 924-1313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME0047929
FL
2084N0400X
Neurology Physician
Primary
ME47929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053698900
—
FL
Enumeration date
07/25/2006
Last updated
06/25/2015
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