# JOSE BALBOA BLANCO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1902252125
- **Gender:** Man
- **Credential:** SURGICAL ASSISTANT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246ZC0007X | Surgical Assistant | 15-483 | CO | — |
| 363AS0400X | Surgical Physician Assistant | 238.000547 | IL | Yes |

## Other

- **Enumeration date:** 05/06/2016
- **Last updated:** 06/07/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | B411427823290 | DRIVER LICENCE | FL |