| Dr Ballester, Professional Limited Company | |
|
602 Coventry Rd Davenport FL 33897-3899 | |
| (863) 424-0194 | |
| Not Available |
| Full Name | Dr Ballester, Professional Limited Company |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 602 Coventry Rd, Davenport, Florida |
| Authorized Official Name and Position | Sandra Marie Ballester (LICENSED PSYCHOLOGIST/ MANAGER) |
| Authorized Official Contact | 8634240194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ballester, Professional Limited Company Po Box 135157 Clermont FL 34713-5157 Ph: (863) 424-0194 | Dr Ballester, Professional Limited Company 602 Coventry Rd Davenport FL 33897-3899 Ph: (863) 424-0194 |
| NPI Number | 1548439409 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 03/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548439409 | NPI | - | NPPES |
| 1548439409 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 7428 (Florida) | Primary |
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