MEDICAL PAVILION CLINC
Managed Care Organizations at Harbor Blvd, Port Charlotte, FL

License number
Florida ME0044391
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: DAVID S BALLESTAS
Title: DOCTOR - OWNER
Phone: (941) 629-9190
Address
Address
2525 Harbor Blvd SUITE 102, Port Charlotte, FL 33952
National Provider ID: 1063671683
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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