Healthcare Provider Details

I. General information

NPI: 1427782804
Provider Name (Legal Business Name): CAROLINA ISABEL CARABALLO FELICIANO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALTURAS DE YAUCO CALLE 11 M.16
YAUCO PR
00698
US

IV. Provider business mailing address

HC 1 BOX 10308
GUAYANILLA PR
00656-9718
US

V. Phone/Fax

Practice location:
  • Phone: 939-731-3010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number4401
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: