MEDICARE: MRS. NERY DENISSE BALCACER-ESTEVEZ 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
1	207RI0200X	Infectious Disease Physician	ME1063153	FL

General Provider Information

NPI Number	:	1477735868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NERY DENISSE BALCACER-ESTEVEZ MD

Provider Business Mailing Address
First Line	:	1700 66TH ST. N.
Second Line	:	STE #510
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33710
Country	:	US
Telephone Number	:	727-384-2479
Fax Number	:	727-384-3573

Provider Business Practice Location Address
First Line	:	8207 113TH STREET NORTH
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772
Country	:	US
Telephone Number	:	727-397-3991
Fax Number	:	727-391-4746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	11/05/2020

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