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Individual

JORGE BALLESTER MALDONADO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
CARR 129 KM 1.0 AVE SAN LUIS, ARECIBO, PR 00613
(787) 680-7318
Mailing address
PO BOX 317, LARES, PR 00669-0317
(787) 680-7318

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
19775
PR
207RC0000X
Cardiovascular Disease Physician
Primary
19775
PR

Other

Enumeration date
04/08/2015
Last updated
11/03/2022
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