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General NPI Number Information
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NPI Number | 1306977988
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Entity Type | Individual
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Provider Name | ANIBAL J. CARABALLO SR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | CARR PR 14 KM 80.4 PARQUE INDUSTRIAL BO. PUEBLO
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City | AIBONITO
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State | PR
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Zip | 00705-0073
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Country | US
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Telephone | 787-739-8182
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Fax |
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Provider Business Mailing Address
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Address Line | 27 CALLE BALDORIOTY
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City | SABANA GRANDE
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State | PR
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Zip | 00637-1727
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Country | US
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Telephone | 787-504-8735
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6670
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License Number State | PR
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