Provider Demographics
NPI:1841430121
Name:ORTIZ CARBALLOSA, NAARA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:NAARA
Middle Name:
Last Name:ORTIZ CARBALLOSA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SW 8TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1580
Mailing Address - Country:US
Mailing Address - Phone:305-794-1537
Mailing Address - Fax:
Practice Address - Street 1:22 SW 8TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-1580
Practice Address - Country:US
Practice Address - Phone:305-794-1537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-26
Last Update Date:2025-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11040627363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily