Provider Demographics
NPI:1649048224
Name:BALLESTER OMS, HARRY LOUIS
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:LOUIS
Last Name:BALLESTER OMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIUM NEW CENTER PLAZA 210 AVE. JOSE OLIVER
Mailing Address - Street 2:APT. 1002
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2977
Mailing Address - Country:US
Mailing Address - Phone:407-780-4298
Mailing Address - Fax:
Practice Address - Street 1:CONDOMINIUM NEW CENTER PLAZA 210 AVE. JOSE OLIVER
Practice Address - Street 2:APT. 1002
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2977
Practice Address - Country:US
Practice Address - Phone:407-780-4298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program