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General NPI Number Information
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NPI Number | 1164132999
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Entity Type | Individual
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Provider Name | VALERIE F. CARBALLOSA APRN
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Gender | Female
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 708 GOODLETTE RD. NORTH SUITE 200, 2ND FLOOR
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City | NAPLES
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State | FL
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Zip | 34102-5644
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Country | US
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Telephone | 239-231-7260
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Fax | 239-567-3667
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Provider Business Mailing Address
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Address Line | PO BOX 749495
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City | ATLANTA
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State | GA
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Zip | 30374-9495
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Country | US
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Telephone | 855-963-2100
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Fax | 813-321-1296
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9463173
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11023441
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License Number State | FL
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