Ballestas, Carlos Enrique

Ballestas, Carlos Enrique is an individual health care provider with primary practice located at 12651 W Sunrise Blvd Ste 202 , Sunrise FL 33323-0906. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ballestas, Carlos Enrique can be contacted via phone (954) 838-8801.

Contact Information

Primary practice address
12651 W Sunrise Blvd Ste 202 Sunrise FL 33323-0906
Phone: (954) 838-8801
Fax: (954) 838-8807
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M2549 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME110974 Florida

Profile Details

NPI number 1609812437
LBN Legal business name Ballestas, Carlos Enrique
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Feb 10th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609812437 NPPES
Texas MEDICAID 1791238-02

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