Most Relevant Information
Provider Data
| NPI Number: | 1003502568 |
| Provider Name: | KRISIA MARIA BANEGAS CARBALLO M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/17/2023 |
| Last Updated: | 08/11/2023 |
Provider Practice Location
1611 NW 12 AVENUE
MIAMI
FL
33136
Practice Location Phone/Fax
| Phone: | 3053551122 |
| Fax: |
Provider Mailing Location
1611 NW 12 AVENUE
MIAMI
FL
33136
Provider Mailing Phone/Fax
| Phone: | 3053551122 |
| Fax: |