Provider Demographics
NPI:1174709679
Name:BALESTRA-FRANCHAK, MARIA TERESA (MSPT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:TERESA
Last Name:BALESTRA-FRANCHAK
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:TERESA
Other - Last Name:BALESTRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1550 MENDAVIA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1610
Mailing Address - Country:US
Mailing Address - Phone:305-297-5582
Mailing Address - Fax:
Practice Address - Street 1:1550 MENDAVIA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-1610
Practice Address - Country:US
Practice Address - Phone:305-297-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT207592251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics