MEDICARE: DR. CESAR MANUEL CARBALLO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	24137	PR

General Provider Information

NPI Number	:	1457733545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CESAR MANUEL CARBALLO M.D.

Provider Business Mailing Address
First Line	:	22 CALLE FORTE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00913-4712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 CALLE FORTE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00913-4712
Country	:	US
Telephone Number	:	787-758-2525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2015
Last Update Date	:	02/19/2025

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