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Individual
JOSE BALBOA BLANCO
Active
Individual
JOSE BALBOA BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SURGICAL ASSISTANT
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
15-483
CO
363AS0400X
Surgical Physician Assistant
Primary
238.000547
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B411427823290
DRIVER LICENCE
FL
Enumeration date
05/06/2016
Last updated
06/07/2025
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