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General NPI Number Information
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NPI Number | 1679506778
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Entity Type | Organization
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Legal Business Name | FRANK BALLESTERIS MD PA
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 946 SW 82ND AVE
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City | MIAMI
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State | FL
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Zip | 33144-4270
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Country | US
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Telephone | 786-201-4458
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Fax |
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Provider Business Mailing Address
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Address Line | 946 SW 82ND AVE
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City | MIAMI
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State | FL
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Zip | 33144-4270
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Country | US
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Telephone | 786-201-4458
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Fax |
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Authorized Official
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Title or Position | M.D.
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Name | FRANK BALLESTEROS
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Credential |
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Telephone | 3057862014458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME55074
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License Number State | FL
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