NPIMap

Organization Active NPI

Dr Ballester, Professional Limited Company

  • Clinical Psychologist
  • Davenport, FL
National Provider Identifier
1548439409
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 7428 Issued in FL
Legal business name
DR BALLESTER, PROFESSIONAL LIMITED COMPANY
Practice address
602 Coventry Rd
Davenport, FL 33897-3899
Phone
(863) 424-0194
NPI assigned
Feb 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Authorized official

Name
Dr. Sandra Marie Ballester, PSY.D.
Title
Licensed Psychologist/ Manager
Phone
(863) 424-0194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 7428 FL Primary

Addresses

Primary practice location

602 Coventry Rd
Davenport, FL 33897-3899

Mailing address

PO Box 135157
Clermont, FL 34713-5157
Phone (863) 424-0194

Other identifiers 1

IdentifierTypeStateIssuer
1548439409OtherFLNPI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1548439409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 135157",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347135157",
            "telephone_number": "863-424-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 COVENTRY RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338973899",
            "telephone_number": "863-424-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BALLESTER, PROFESSIONAL LIMITED COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "BALLESTER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/ MANAGER",
        "authorized_official_telephone_number": "863-424-0194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548439409",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.