Provider Demographics
NPI:1306977988
Name:CARABALLO, ANIBAL J SR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:J
Last Name:CARABALLO
Suffix:SR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:27 CALLE BALDORIOTY
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1727
Mailing Address - Country:US
Mailing Address - Phone:787-504-8735
Mailing Address - Fax:
Practice Address - Street 1:CARR PR 14 KM 80.4
Practice Address - Street 2:PARQUE INDUSTRIAL BO. PUEBLO
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-0073
Practice Address - Country:US
Practice Address - Phone:787-739-8182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist