Samira Caraballo

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

PA9112599 Issued in FL

Practice address

707 W Eau Gallie Blvd
Melbourne, FL 32935-5958

Phone

(321) 727-3223

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

No

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

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

Physician Assistant

State licenses

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.

• Baptist Health Medical Group Physicians LLC

  • Specialist
  • Miami, FL
  • NPI 1891893343
  Medicare reassignment
• Bermax II LLC

  • Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
  • Melbourne, FL
  • NPI 1326374901
  Medicare reassignment

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1770134231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 NE MIAMI PL APT 1611",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331321355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355958",
            "telephone_number": "321-727-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "SAMIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "PA9112599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Eric Caplan, MD
• Sherri Fair Caplan, DO
• Kimberly Cappelen
• Bradley Edward Capps, OTR/L
• Heather Elysabeth Capps, APRN, FNP-C
• Ryan Francis Carature, PA-C
• Charnada R Cardell, RCSWI
• Alicia N Carden, APRN
• Vanessa Cardeno
• Alexandra Cardillo-Gonzalez

• Plastic and Reconstructive Surgery Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.