Individual
MR. SERGIO ROBERTO CEBALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6506 N FLORIDA AVE, STE 101, TAMPA, FL 33604-6060
(813) 964-6872
Mailing address
7506 COLONIAL CT, TAMPA, FL 33615-1546
(813) 480-5046
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
MA54554
FL
Other
Enumeration date
09/29/2008
Last updated
09/30/2008
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