Individual provider · NPI-1

David S Ballestas, MD

Internal Medicine · Port Charlotte, FL

NPI number1609969419
StatusActive
Last updated in NPPESMay 9, 2008

Details

NPI
1609969419
Entity type
Individual (NPI-1)
Name
David S Ballestas
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Oct 2, 2006
Last updated
May 9, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineME0044391FLYes
208D00000X General PracticeME0044391FL

Practice location

2525 Harbor Blvd
Suite 102
Port Charlotte, FL 33952

Phone 941-629-7593 · Fax 941-625-2751

Mailing address

2525 Harbor Blvd
Suite 102
Port Charlotte, FL 33952

Phone 941-629-7593 · Fax 941-625-2751

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