Provider Demographics
NPI:1477735868
Name:BALCACER-ESTEVEZ, NERY DENISSE (MD)
Entity Type:Individual
Prefix:MRS
First Name:NERY
Middle Name:DENISSE
Last Name:BALCACER-ESTEVEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DENISSE
Other - Middle Name:
Other - Last Name:BALCACER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1700 66TH ST. N.
Mailing Address - Street 2:STE #510
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710
Mailing Address - Country:US
Mailing Address - Phone:727-384-2479
Mailing Address - Fax:727-384-3573
Practice Address - Street 1:8207 113TH STREET NORTH
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772
Practice Address - Country:US
Practice Address - Phone:727-397-3991
Practice Address - Fax:727-391-4746
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1063153207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease