Eduardo Caraballo
Individual provider Active NPI General Practice Dentistry · Yauco, PR
NPI 1144216680 · NPPES record last updated Oct 12, 2016
Key facts
- NPI
- 1144216680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2268 (PR)
- Practice address
- 520 Calle Madrid
Mansiones de Monterrey
Yauco, PR 00698-2565 - Phone
- (787) 856-3525
- Fax
- (787) 856-3525
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170110000482 | PR | Order and Referring Only - Dentist |
1052692886 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2268 | PR | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2268 | PR | Yes |
Addresses
Primary practice location
520 Calle Madrid
Mansiones de Monterrey
Yauco, PR 00698-2565
Mailing address
28 Calle Mattei Lluberas
Yauco, PR 00698-3635
Phone (787) 856-3525
Other providers in Yauco, PR
- Jose M Canabal Enriquez
- Carolina Isabel Caraballo Feliciano
- Nashaly Caraballo Torres
- Wanda Y Caraballo-Guzman
- Alexis Caraballo
- Genesis Maria Caraballo
- Camila Isabel Carattini Sanchez
- Yeissa Marie Carbo Rivera
- Caribbean Imaging and Radiation Treatment Center,Inc
- Carpe Diem, Inc
All providers in Yauco, PR · General Practice Dentistry in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.