Provider Demographics
NPI:1457478679
Name:BALEN, JOSEPH SCOTT (DC, ND)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SCOTT
Last Name:BALEN
Suffix:
Gender:M
Credentials:DC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 FRUITVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-5336
Mailing Address - Country:US
Mailing Address - Phone:941-363-0000
Mailing Address - Fax:941-350-1394
Practice Address - Street 1:2801 FRUITVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5336
Practice Address - Country:US
Practice Address - Phone:941-363-0000
Practice Address - Fax:941-350-1394
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7535111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCH7535OtherFLORIDA MEDICAL LICENSE
FL74909OtherBCBS GROUP NUMBER
FL74909OtherBCBS GROUP NUMBER
FL53872ZMedicare ID - Type Unspecified