Individual
MILVA BALLESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5222 ANDRUS AVE STE C, ORLANDO, FL 32810-5456
(407) 745-5022
Mailing address
130 BRISTOL FOREST TRL, SANFORD, FL 32771-7997
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010616500
—
FL
Enumeration date
10/10/2017
Last updated
10/10/2017
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