Johan Orlando Fundora Caraballo, MS SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

8828 NW 112TH Ter
Hialeah Gardens, FL 33018-4534

Phone

(305) 680-9627

NPI assigned

Sep 19, 2023

Last updated

Sep 19, 2023By the provider in NPPES

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

Credentials

Master of Science

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1649058843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8828 NW 112TH TER",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330184534",
            "telephone_number": "305-680-9627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8828 NW 112TH TER",
            "city": "HIALEAH GARDENS",
            "state": "FL",
            "postal_code": "330184534",
            "telephone_number": "305-680-9627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDORA CARABALLO",
        "first_name": "JOHAN",
        "middle_name": "ORLANDO",
        "credential": "MS SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Hialeah Gardens, FL
• Providers in Hialeah Gardens, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.