DR. LEONIDES CARBALLOSA M.D. NPI 1003801911

Pediatrics in Hialeah, FL

Individual Male Pediatrics

About LEONIDES CARBALLOSA

Leonides Carballosa is a provider established in Hialeah, Florida and his medical specialization is pediatrics. The NPI number of Leonides Carballosa is 1003801911 and was assigned on September 2005. The practitioner's primary taxonomy code is 208000000X with license number ME49239 (FL). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI

1003801911

Provider NameDR. LEONIDES CARBALLOSA M.D.
Provider Location Address5378 W 16TH AVE HIALEAH, FL 33012
Provider Mailing Address14900 EGAN LN MIAMI LAKES, FL 33014
GenderMale
NPI Entity TypeIndividual
Is Sole Proprietor?Yes
Is Organization Subpart?N/A
Enumeration Date09-16-2005
Last Update Date10-07-2019

Primary Taxonomy

Taxonomy Code208000000X
ClassificationPediatrics
TypeAllopathic & Osteopathic Physicians
License No.ME49239
License StateFL
Taxonomy DescriptionA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Business Address

DR. LEONIDES CARBALLOSA M.D.
5378 W 16TH AVE
HIALEAH, FL
ZIP 33012
Phone: (305) 820-4101
Fax: (305) 820-2885

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Mailing Address

DR. LEONIDES CARBALLOSA M.D.
14900 EGAN LN
MIAMI LAKES, FL
ZIP 33014
Phone: (305) 505-2780

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
045652700MEDICAID (05)FL

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003848268 VANDELY PEREZ MD
Individual
General Practice5378 W 16TH AVE
HIALEAH, FL 33012
(305) 820-4101
1043682826 IVAN RAFAEL GARCIA MARTINEZ ARNP
Individual
Nurse Practitioner (Family)5378 W 16TH AVE
HIALEAH, FL 33012
(305) 820-4101
1114439841 NELVA ROSA PUERTOLAS ARNP
Individual
Nurse Practitioner (Family)5378 W 16TH AVE
HIALEAH, FL 33012
(305) 820-4101
1265837348 ARIEL J PEREZ ARNP
Individual
Nurse Practitioner (Family)5378 W 16TH AVE
HIALEAH, FL 33012
(305) 820-4101

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.