Provider Demographics
NPI:1538130588
Name:BATLLE, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CARLOS
Last Name:BATLLE
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:PO BOX 919336
Mailing Address - Street 2:#2
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9336
Mailing Address - Country:US
Mailing Address - Phone:617-653-5600
Mailing Address - Fax:
Practice Address - Street 1:8900 N. KENDALL DRIVE
Practice Address - Street 2:FND-216
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2118
Practice Address - Country:US
Practice Address - Phone:786-596-1960
Practice Address - Fax:305-273-0254
Is Sole Proprietor?:No
Enumeration Date:2006-01-29
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-2242022085R0202X
FLME1056212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC176176OtherSTATE MEDICAL LICENSE