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Individual

DR. JESUS MANUEL BALESTRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 AVE LAUREL, URB SANTA JUANITA, BAYAMON, PR 00956-4816
(787) 786-6165
Mailing address
HC 67 100, MANSIONES DE SIERRA TAINA, BAYAMON, PR 00956
(787) 786-7678

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5014
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5014
LICENSE NUMBER
PR
Enumeration date
04/10/2007
Last updated
07/08/2007
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