Ballestas, David S

Ballestas, David S is an individual health care provider with primary practice located at 2525 Harbor Blvd Suite 102, Port Charlotte FL 33952. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Ballestas, David S can be contacted via phone (941) 629-7593.

Contact Information

Primary practice address
2525 Harbor Blvd Suite 102 Port Charlotte FL 33952
Phone: (941) 629-7593
Fax: (941) 625-2751
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0044391 Florida
Allopathic & Osteopathic Physicians / General Practice 208D00000X ME0044391 Florida

Profile Details

NPI number 1609969419
LBN Legal business name Ballestas, David S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated May 9th, 2008 - about 16 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 1609969419 NPPES
Florida MEDICAID 068916500

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