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General NPI Number Information
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NPI Number | 1225359714
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Entity Type | Organization
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Legal Business Name | LINDA CARABALLO, MSPT, PA
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Dates
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Enumeration Date | 06/18/2010
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 12525 SW 62ND AVE
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City | MIAMI
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State | FL
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Zip | 33156-5616
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Country | US
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Telephone | 305-299-2628
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Fax |
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Provider Business Mailing Address
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Address Line | 12525 SW 62ND AVE
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City | MIAMI
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State | FL
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Zip | 33156-5616
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Country | US
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Telephone | 305-299-2628
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LINDA CARABALLO
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Credential | MSPT
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Telephone | 305-299-2628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT 0015186
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License Number State | FL
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