Provider Demographics
NPI:1477099083
Name:BALA, NITIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NITIN
Middle Name:
Last Name:BALA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3529 E SILVER SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-6403
Mailing Address - Country:US
Mailing Address - Phone:352-622-5298
Mailing Address - Fax:352-622-4268
Practice Address - Street 1:3529 E SILVER SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6403
Practice Address - Country:US
Practice Address - Phone:352-622-5298
Practice Address - Fax:352-622-4268
Is Sole Proprietor?:No
Enumeration Date:2017-01-07
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist