Ballast Medical Management, LLC.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

BALLAST MEDICAL MANAGEMENT, LLC.

Practice address

9200 S Dadeland Blvd Ste 208
Miami, FL 33156-2707

Phone

(786) 326-2830

NPI assigned

Jan 12, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Omar Montesino Jr.

Title

Chief Executive Officer

Phone

(786) 615-2572

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1447768452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 S DADELAND BLVD STE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562707",
            "telephone_number": "786-326-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 S DADELAND BLVD STE 208",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562707",
            "telephone_number": "786-326-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALLAST MEDICAL MANAGEMENT, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "MONTESINO",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "786-615-2572",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tia A Ball
• Ana Maria Balladares, PHARMACIST
• Jorge L Balladares, DDS
• Camila Ballart Alvarez, (BCABA,CBHCM, RBT)
• Mauricio Ballart, RBT
• Eliana E Ballast
• Annia Ballate Delgado
• Lisdy Ballate
• Ann E Ballen, MD
• Ballent Rehabilitation PA

• Preferred Provider Organization in Miami, FL
• Providers in Miami, FL by specialty
• Preferred Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.