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Organization
FLORIDA EEG LLC
Active
Organization
FLORIDA EEG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BALLESTERO (COO)
(407) 408-2445
Entity
Organization
Contact information
Practice address
117 N KIRKMAN RD STE 3, ORLANDO, FL 32811-1403
(407) 408-2445
Mailing address
117 N KIRKMAN RD STE 3, ORLANDO, FL 32811-1403
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
11/17/2020
Last updated
02/08/2021
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