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General NPI Number Information
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NPI Number | 1427525963
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Entity Type | Organization
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Legal Business Name | COLMEDICAL CARE LLC
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 7824 LAKE UNDERHILL RD STE A
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City | ORLANDO
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State | FL
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Zip | 32822-8201
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Country | US
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Telephone | 407-286-2801
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Fax | 407-449-7073
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Provider Business Mailing Address
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Address Line | 7824 LAKE UNDERHILL RD STE A
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City | ORLANDO
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State | FL
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Zip | 32822-8201
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Country | US
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Telephone | 407-286-2801
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Fax | 407-449-7073
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MR. JORGE G BALLESTEROS
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Credential | PA
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Telephone | 407-286-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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