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General NPI Number Information
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NPI Number | 1447584826
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Entity Type | Individual
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Provider Name | YVETTE CARBALLOSA-HERNANDEZ P.A.
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Gender | Female
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 6141 SUNSET DR STE 501
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5026
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Country | US
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Telephone | 305-661-6615
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Fax | 305-661-6619
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Provider Business Mailing Address
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Address Line | 6141 SUNSET DR STE 501
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5026
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Country | US
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Telephone | 305-661-6615
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Fax | 305-661-6619
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9105203
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License Number State | FL
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