Individual provider · NPI-1

Leidys Stefanye Ballestas Ruiz, SA-

Specialist/Technologist, Other, Surgical Assistant · Pembroke Pines, FL

NPI number1861966889
StatusActive
Last updated in NPPESJan 12, 2019

Details

NPI
1861966889
Entity type
Individual (NPI-1)
Name
Leidys Stefanye Ballestas Ruiz
Credential
SA-
Sex
Female
Sole proprietor
Yes
Enumeration date
Jan 12, 2019
Last updated
Jan 12, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246ZC0007X Specialist/Technologist, Other, Surgical Assistant18-365FLYes

Practice location

10005 Nw 4th St
Pembroke Pines, FL 33024-6196

Phone 954-529-9062

Mailing address

10005 Nw 4th St
Pembroke Pines, FL 33024-6196

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