Healthcare Provider Details

I. General information

NPI: 1487517520
Provider Name (Legal Business Name): DARLYN TAIRIE CARABALLO PEREZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49-61 CALLE GARCIA
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 144021
ARECIBO PR
00614-4021
US

V. Phone/Fax

Practice location:
  • Phone: 787-817-4973
  • Fax:
Mailing address:
  • Phone: 787-309-2943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1836
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: