Provider Demographics
NPI:1316582109
Name:BALAN, MICHEL (ARNP-C)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:BALAN
Suffix:
Gender:M
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 NW 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2744
Mailing Address - Country:US
Mailing Address - Phone:786-238-7282
Mailing Address - Fax:833-927-2568
Practice Address - Street 1:1470 NW 107TH AVE STE M
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2735
Practice Address - Country:US
Practice Address - Phone:786-238-7282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005025363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily