Organization Name: | MEDICAL PAVILION CLINC |
NPI Number: | 1063671683 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID S BALLESTAS (DOCTOR - OWNER) |
Mailing Address: | 2525 Harbor Blvd Suite 102 Port Charlotte |
State: | FL US |
Postal Code: | 339525317 |
Phone Number: | 9416299190 |
Fax Number: | 9416252751 |
NPI Enumeration Date: | 06/09/2008 |
NPI Last Update Date: | 06/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 305R00000X |
License Number: | ME0044391 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Preferred Provider Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |