Individual provider Active NPI

Jose H Caraballo, LCSW

  • Clinical Social Worker
  • Hialeah, FL
National Provider Identifier
1063804177
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14966 Issued in FL
Practice address
4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone
(305) 825-0300
NPI assigned
Feb 26, 2015
Last updated
Nov 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14966 FL Primary

Addresses

Primary practice location

4175 W 20TH Ave
Hialeah, FL 33012-5874

Mailing address

3865 W 9TH Ave
Hialeah, FL 33012-7284
Phone (305) 968-1257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231129001077 FL Practitioner - Clinical Social Worker 6002264215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Barry University School of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Citrus Health Network, Inc.Group PAC ID 9931177334, 49 clinicians

Practice addresses (Care Compare)

4125 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 424-3120

4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 825-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14966FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 10, 2024 Accepting new patients
Citrus Health Network, Inc. CurrentSince Oct 18, 2023 Accepting new patients
Citrus Health Network Inc Current Accepting new patients
Citrus Health Network Inc CurrentSince Oct 18, 2023 Accepting new patients

Locations

4175 W 20th Ave
Hialeah, FL 33012
Phone (305) 424-3030

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1063804177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 W 9TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330127284",
            "telephone_number": "305-968-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125874",
            "telephone_number": "305-825-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "JOSE",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "14966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.