Medical Pavilion Clinic

LBN: David S Ballestas Md Pa
Medical Pavilion Clinic is an health care organization with primary practice located at 2525 Harbor Blvd Suite 102, Port Charlotte FL 33952-5317. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. David S Ballestas Md Pa can be contacted via phone (941) 629-7593, or through Ballestas, David S. via phone (941) 629-7593.

Contact Information

Primary practice address
2525 Harbor Blvd Suite 102 Port Charlotte FL 33952-5317
Phone: (941) 629-7593
Fax: (941) 625-2751
Website:
Map and Directions
Authorized official contact:
Name: Ballestas, David S. Doctor of Medicine (MD)
Phone: (941) 629-7593

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X H87694 Florida

Profile Details

NPI number 1093901282
LBN Legal business name David S Ballestas Md Pa
DBA Doing business as Medical Pavilion Clinic
Authorized official Ballestas, David S. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2007
Last updated May 9th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093901282 NPPES
Florida Other 40389 MEDICARE GROUP NUMBER

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