Mauro Carballo

Primary specialty

DentistTaxonomy code 122300000X

License

DN 21572 Issued in FL

Practice address

900 Park Centre Blvd Ste 400a
Miami Gardens, FL 33169-5371

Phone

(305) 912-8603

NPI assigned

Apr 19, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Magic Dental Design, PLLC

  • General Practice Dentistry
  • Miami, FL
  • NPI 1609747302
  NPD

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1508200635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3165 SW 108TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331652449",
            "telephone_number": "305-215-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PARK CENTRE BLVD STE 400A",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695371",
            "telephone_number": "305-912-8603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2664 Tamiami Trl E",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341125707",
            "country_code": "US",
            "telephone_number": "239-428-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 NW 17th Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331252327",
            "country_code": "US",
            "telephone_number": "305-912-8603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBALLO",
        "first_name": "MAURO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-19",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Capote Services Corp
• Iradiel Caraballo Viera
• Carami Healthcare LLC
• Yansay Carballo Garcia
• Erlen Carballo Pardillo
• Odalys C Carbonell
• Kristine Cardenas
• Sandra L Cardenas, RD
• Banessa Cardentey Borroto
• Mariana Cardoso Gonzalez, SA-C

• Dentist in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.