Provider Demographics
NPI:1750263216
Name:CELIN CARABALLO LLC
Entity type:Organization
Organization Name:CELIN CARABALLO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TAX ID OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CELIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARABALLO
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:440-342-8679
Mailing Address - Street 1:2709 FRANKLIN BLVD FL 2E
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2993
Mailing Address - Country:US
Mailing Address - Phone:216-696-4140
Mailing Address - Fax:
Practice Address - Street 1:2709 FRANKLIN BLVD FL 2E
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-2993
Practice Address - Country:US
Practice Address - Phone:216-696-4140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty