MEDICARE: MR. FERDINANDO (FRED) BALESTRIERO NHA, LHRM

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5503061	OTHER	FL	HEALTHCARE RISK MANAGER LICENCE
2	NH3369	OTHER	FL	NHA LICENSE

General Provider Information

NPI Number	:	1871918409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FERDINANDO (FRED) BALESTRIERO NHA, LHRM

Provider Business Mailing Address
First Line	:	1511 NE 33RD ST
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6731
Country	:	US
Telephone Number	:	954-782-0678
Fax Number	:	954-782-9377

Provider Business Practice Location Address
First Line	:	1511 NE 33RD ST
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-6731
Country	:	US
Telephone Number	:	954-782-0678
Fax Number	:	954-782-9377

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

Provider Enumeration Date	:	02/18/2014
Last Update Date	:	10/01/2014

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