Patricia Damaris Caraballo, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F02210869 Issued in FL

Practice address

4850 W Oakland Park Blvd Ste 136
Lauderdale Lakes, FL 33313-7277

Phone

(954) 945-3530

NPI assigned

Nov 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Ezra Medical LLC

  • Internal Medicine Physician
  • Hollywood, FL
  • NPI 1285404962
  Medicare reassignment NPD
• Nova Medical Services - Wound Care Division LLC

  • Family Medicine Physician
  • Miami, FL
  • NPI 1578145793
  Medicare reassignment NPD
• Roberto Polanco MD PA

  • Specialist
  • Miami, FL
  • NPI 1669653291
  Medicare reassignment NPD

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624147200000",
    "number": "1285102749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 136",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137277",
            "telephone_number": "954-945-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD STE 136",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137277",
            "telephone_number": "954-945-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "PATRICIA",
        "middle_name": "DAMARIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-02",
        "last_updated": "2021-06-20",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9397881",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F02210869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1285102749",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "HIALEAH",
            "affiliation": "N",
            "address_1": "18610 NW 87th Ave Ste 101",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330153519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nelson Ahmed Calvo, APRN
• James D Camden, PT
• Krystle L Cameron
• Fiona D Campbell, RN
• Richard Clive Campbell
• Carefinders Homecare LLC
• Lester Rafael Carmenate Aquino, MD
• Marie Michelle Carner, NP
• Daniel Charles Carney Sr., DO
• Philippe Jacques Carrie, M.D.

• Family Nurse Practitioner in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.