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General NPI Number Information
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NPI Number | 1407931918
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Entity Type | Organization
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Legal Business Name | CF PEDIATRIC CARE CENTER P.S.C.
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CALLE CAZUL #52 URB. VALENCIA UNO
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City | JUNCOS
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State | PR
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Zip | 00777
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Country | US
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Telephone | 787-617-2072
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Fax |
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Provider Business Mailing Address
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Address Line | AVENTURA 7802 ENCANTADA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976
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Country | US
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Telephone | 787-617-2072
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Fax |
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Authorized Official
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Title or Position | PEDIATRICIAN
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Name | DR. NILKA CARABALLO
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Credential | M.D.
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Telephone | 787-617-2072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 13482
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License Number State | PR
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