MEDICARE: DR. DANIEL A CARABALLO DO

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	207RC0000X	Cardiovascular Disease Physician	OS18313	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	XC234	OTHER	FL	HFMG

General Provider Information

NPI Number	:	1891275202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL A CARABALLO DO

Provider Business Mailing Address
First Line	:	3700 WASHINGTON ST STE 500A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-8256
Country	:	US
Telephone Number	:	954-989-4700
Fax Number	:	954-989-4754

Provider Business Practice Location Address
First Line	:	2213 N UNIVERSITY DR STE A
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3611
Country	:	US
Telephone Number	:	954-963-2151
Fax Number	:	954-966-6629

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

Provider Enumeration Date	:	08/15/2018
Last Update Date	:	04/15/2026

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