Individual
LEIDYS STEFANYE BALLESTAS RUIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-
Contact information
Practice address
10005 NW 4TH ST, PEMBROKE PINES, FL 33024-6196
(954) 529-9062
Mailing address
10005 NW 4TH ST, PEMBROKE PINES, FL 33024-6196
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
18-365
FL
Other
Enumeration date
01/12/2019
Last updated
01/12/2019
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