MEDICARE: MRS. SEMIRAMIS NIEVES CARABALLO

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	174H00000X	Health Educator	IPHMNM19926	FL
2	171400000X	Health & Wellness Coach	IPHMNM19926	FL
3	374U00000X	Home Health Aide		FL

General Provider Information

NPI Number	:	1871280776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SEMIRAMIS NIEVES CARABALLO

Provider Business Mailing Address
First Line	:	35 SE 1ST AVE STE 200Q
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-2177
Country	:	US
Telephone Number	:	786-259-5441
Fax Number	:	352-310-0132

Provider Business Practice Location Address
First Line	:	35 SE 1ST AVE STE 200K
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34471-2177
Country	:	US
Telephone Number	:	786-259-5441
Fax Number	:	352-310-0132

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

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	03/02/2026

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