Individual
JUAN CAMILO DUQUE BALLESTEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 NW 14TH ST STE 809A, MIAMI, FL 33136-2107
(305) 243-6251
Mailing address
600 NE 27TH ST APT 1802, MIAMI, FL 33137-5096
(786) 452-2127
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME143258
FL
207RN0300X
Nephrology Physician
S0279
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2014
Last updated
02/20/2020
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