MEDICARE: CELIN CARABALLO LLC

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1750263216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CELIN CARABALLO LLC

Provider Business Mailing Address
First Line	:	2709 FRANKLIN BLVD FL 2E
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-2993
Country	:	US
Telephone Number	:	216-696-4140
Fax Number	:

Provider Business Practice Location Address
First Line	:	2709 FRANKLIN BLVD FL 2E
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-2993
Country	:	US
Telephone Number	:	216-696-4140
Fax Number	:

Authorized Official
Title or Position	:	TAX ID OWNER
Name	:	CELIN CARABALLO
Credential	:	CNP
Telephone Number	:	440-342-8679

Provider Enumeration Date	:	07/24/2025
Last Update Date	:	07/24/2025

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Directions to “CELIN CARABALLO LLC ” Practice Location

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