CARLOS A BACALLAO (NPI# 1043736176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043736176 |
| Entity Type | Individual |
| Full Name | CARLOS A BACALLAO |
| Credential | ARNP |
| Practice Address |
704 Washington Ave Homestead FL 33030-6012 |
| Mailing Address |
167 W 23rd St Hialeah FL 33010-2211 |
| Practice Telephone | 3052508758 |
| Mailing Telephone | 3058233312 |
| Mailing Fax Number | 3058843989 |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2019-10-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | ARNP9271517 | FL | Allopathic & Osteopathic Physicians |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9271517 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
704 WASHINGTON AVE |
| City | HOMESTEAD |
| State | FL |
| Zip Code | 33030-6012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932625373 | Homestead Medical Center LLC | Internal Medicine | 704 Washington Ave, Homestead, FL 33030-6012 | 2017-08-17 |
| 1003477084 | Homestead Mental Center LLC | Clinic/Center | 704 Washington Ave, Homestead, FL 33030-6012 | 2019-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619515871 | Clinica Las Mercedes Vi, Inc | Clinic/Center | 290 Ne 8 Street, Homestead, FL 33030 | 2019-12-18 |
| 1770124331 | Md Now Medical Centers Inc | Clinic/Center | 729 S Homestead Blvd, Homestead, FL 33030 | 2019-10-04 |
| 1437611787 | Yevgeniy Mailyan | Behavior Technician | 1513 Sw 2nd Court, Homestead, FL 33030 | 2019-04-04 |
| 1144789306 | Special Delivery Health Center, LLC | Midwife | 123 N. Krome Avenue, Suite 101, Homestead, FL 33030 | 2019-03-18 |
| 1144718578 | Galovin Solutions Inc | Behavioral Analyst | 50 Nw 15th St Ste 111, Homestead, FL 33030 | 2018-05-01 |
| 1003332073 | Juan C Gonzalez Ibarra | Behavior Technician | 800 Ne 12th Ave Apt# C214, Homestead, FL 33030 | 2017-08-21 |
| 1023534757 | Lunilda L Mcvay | Psychologist | 151 Nw 11st St Suite W-201, Monarch All Health, LLC, Homestead, FL 33030 | 2017-08-15 |
| 1295250025 | Clara L Perez | Behavior Technician | 800 Ne 12th Ave Apt# L256, Homestead, FL 33030 | 2017-08-14 |
| 1205350535 | Charity's Homemaker Companion Services, LLC | Homemaker | 30855 Sw 205 Ave, Homestead, FL 33030 | 2017-07-28 |
| 1003346693 | Yanet Rodriguez Sardinas | Behavioral Analyst | 906 Nw 3rd Ave, Homestead, FL 33030 | 2017-06-15 |
| Find all providers in zip 33030 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821655440 | Leonardo Sanchez Lopez | Nurse Practitioner | 11420 Sw 250th St, Homestead, FL 33032-6039 | 2019-05-20 |
| 1982172656 | Dianellis Marron | Nurse Practitioner | 11584 Sw 244th Ln, Homestead, FL 33032-4716 | 2018-11-11 |
| 1154731941 | Dawn Elizabeth Downing | Nurse Practitioner | 70 Nw 4th St, Homestead, FL 33030-5942 | 2014-05-01 |
| 1972942597 | Patricia Herrand | Nurse Practitioner | 925 Ne 30th Terrace, Suite 310, Homestead, FL 33033-7614 | 2013-06-17 |
| 1528390663 | Professional Nurse Practitioner Inc | Nurse Practitioner | 29157 Sw 186th Ave, Homestead, FL 33030-2439 | 2010-01-30 |
| 1932680022 | Sapna Rao | Nurse Practitioner | 9760 Sw 344th St, Homestead, FL 33035-1800 | 2018-08-27 |
| 1154837623 | Yonaisa Jordana | Nurse Practitioner | 654 Ne 9th Pl, Homestead, FL 33030 | 2017-12-20 |
| 1104276013 | Maria Jessica Londono | Nurse Practitioner | 975 Baptist Way, Hospitalist's Office-2nd Floor Inside PCu, Homestead, FL 33033-7600 | 2016-06-21 |
| 1407293152 | Linda Jean Long | Nurse Practitioner | 975 Baptist Way, Homestead, FL 33033-7600 | 2013-06-03 |
| 1124366471 | Julio Ernesto Gutierrez | Nurse Practitioner | 1443 Ne 8 Street, Homestead, FL 33033 | 2013-01-22 |
| Find all providers in HOMESTEAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.