Provider Demographics
NPI:1255090791
Name:BALOMENOS, PAMELLA DEANNA (DC)
Entity type:Individual
Prefix:DR
First Name:PAMELLA
Middle Name:DEANNA
Last Name:BALOMENOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 ANTIQUERA AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2946
Mailing Address - Country:US
Mailing Address - Phone:305-608-1333
Mailing Address - Fax:
Practice Address - Street 1:1932 NW MIAMI CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1316
Practice Address - Country:US
Practice Address - Phone:305-935-9599
Practice Address - Fax:305-932-5612
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13831111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor