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General NPI Number Information
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NPI Number | 1003615485
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Entity Type | Individual
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Provider Name | VALERY MARIE CARABALLO RIVERA PA
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 450 C. FERROCARRIL BLDG SANTA MARIA MEDICAL BUILDING SUITE 302
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City | PONCE
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State | PR
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Zip | 00731-0000
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Country | US
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Telephone | 787-844-6669
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 10258
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City | PENUELAS
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State | PR
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Zip | 00624-9725
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Country | US
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Telephone | 787-512-5654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2480P.A.
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License Number State | PR
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