Healthcare Provider Details

I. General information

NPI: 1225957178
Provider Name (Legal Business Name): CARIDAD TERESA LLULL TOMBO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 SILVER MEADOW WAY
PLANT CITY FL
33566-0725
US

IV. Provider business mailing address

3407 SILVER MEADOW WAY
PLANT CITY FL
33566-0725
US

V. Phone/Fax

Practice location:
  • Phone: 305-733-1811
  • Fax: --
Mailing address:
  • Phone: 305-733-1811
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number17890-I
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: