Provider Demographics
NPI:1417080565
Name:EDGAR A BATISTA MD PA
Entity Type:Organization
Organization Name:EDGAR A BATISTA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:ARTURO
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-499-4200
Mailing Address - Street 1:7950 NW 53RD ST STE 108
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4681
Mailing Address - Country:US
Mailing Address - Phone:305-499-4200
Mailing Address - Fax:855-420-6315
Practice Address - Street 1:7950 NW 53RD ST STE 108
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4681
Practice Address - Country:US
Practice Address - Phone:305-499-4200
Practice Address - Fax:855-420-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-89120261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty