MEDICARE: ANANAY CARABALLO RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician	20240711139072	FL

General Provider Information

NPI Number	:	1881538213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANANAY CARABALLO RODRIGUEZ

Provider Business Mailing Address
First Line	:	3417 W SAINT CONRAD ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2137
Country	:	US
Telephone Number	:	602-739-8020
Fax Number	:

Provider Business Practice Location Address
First Line	:	3417 W SAINT CONRAD ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2137
Country	:	US
Telephone Number	:	602-739-8020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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