Provider Demographics
NPI:1346287711
Name:BALBIANI, EDUARDO HERBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:HERBERTO
Last Name:BALBIANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27535 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:NARANJA
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8225
Mailing Address - Country:US
Mailing Address - Phone:305-246-2221
Mailing Address - Fax:305-247-8349
Practice Address - Street 1:27535 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:NARANJA
Practice Address - State:FL
Practice Address - Zip Code:33032-8225
Practice Address - Country:US
Practice Address - Phone:305-246-2221
Practice Address - Fax:305-247-8349
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057108173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063744100Medicaid
FL063744100Medicaid