Individual
ANAISYS M BALLESTEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
975 BAPTIST WAY STE 202, HOMESTEAD, FL 33033-7600
(786) 243-8444
(786) 576-0416
Mailing address
PO BOX 198054, ATLANTA, GA 30384-3236
(786) 243-8444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS8354
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265016900
—
FL
01
—
47852
BCBS PROVIDER NO.
FL
Enumeration date
02/20/2007
Last updated
07/11/2022
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