Provider Demographics
NPI:1578733358
Name:MARULL-BALTA, MARIA PILAR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:PILAR
Last Name:MARULL-BALTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5150 NW MILNER DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-3392
Mailing Address - Country:US
Mailing Address - Phone:772-462-3827
Mailing Address - Fax:772-462-3865
Practice Address - Street 1:714 AVENUE C
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4189
Practice Address - Country:US
Practice Address - Phone:772-462-3827
Practice Address - Fax:772-462-3865
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME832912080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine