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NPI Code Detail

MEDICARE: JESSE BALSEIRO MD

MEDICARE: JESSE BALSEIRO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207U00000XNuclear Medicine PhysicianME103629FL
2207Q00000XFamily Medicine PhysicianME103629FL

General Provider Information

NPI Number : 1710203435
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE BALSEIRO MD
Provider Business Mailing Address
First Line : 7224-1 MERRILL RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32277-3725
Country : US
Telephone Number : 407-798-8800
Fax Number : 321-333-4292
Provider Business Practice Location Address
First Line : 4348 SOUTHPOINT BLVD
Second Line : SUITE 100
City : JACKSONVILLE
State : FL
Zip : 32216-0986
Country : US
Telephone Number : 904-281-1915
Fax Number : 904-281-1119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2010
Last Update Date : 06/01/2022

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Directions to “ JESSE BALSEIRO MD” Practice Location

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