Individual
JORGE MANUEL BALLESTEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3714 S SUMMERLIN AVE, ORLANDO, FL 32806-6902
(812) 240-0977
Mailing address
3714 S SUMMERLIN AVE, ORLANDO, FL 32806-6902
(812) 240-0977
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R56975
NM
Other
Enumeration date
06/27/2006
Last updated
05/26/2022
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