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Contact Information

DAVID S BALLESTAS, MD
2525 HARBOR BLVD
SUITE 102
PORT CHARLOTTE, FL33952
 Phone: 941-629-7593
 Fax: 941-625-2751
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for DAVID S BALLESTAS · (Male)

NPI # 1609969419
Status Active
Credentials MD
Entity Individual
Enumeration date 10/02/2006
Last updated 05/09/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME0044391
  • FL Medicaid 068916500
Hospital affiliation(s)
  • CHARLOTTE REGIONAL MEDICAL CENTER - (Acute Care)
    809 E MARION AVE
    PUNTA GORDA, FL 33950
  • FAWCETT MEMORIAL HOSPITAL - (Acute Care)
    21298 OLEAN BLVD
    PORT CHARLOTTE, FL 33952
  • PEACE RIVER REGIONAL MEDICAL CENTER - (Acute Care)
    2500 HARBOR BLVD
    PORT CHARLOTTE, FL 33952
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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