Provider Demographics
NPI:1215533179
Name:CARABALLO ARAQUE, ROSMARY DEL VALLE (RD)
Entity type:Individual
Prefix:
First Name:ROSMARY
Middle Name:DEL VALLE
Last Name:CARABALLO ARAQUE
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 CLEVELAND CLINIC BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3625
Mailing Address - Country:US
Mailing Address - Phone:954-659-5646
Mailing Address - Fax:954-659-6947
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3625
Practice Address - Country:US
Practice Address - Phone:954-659-5646
Practice Address - Fax:954-659-6947
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3093133V00000X
FL9745133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
86108582OtherCOMMISSION ON DIETETIC REGISTRATION CDR