Provider Demographics
NPI:1619293479
Name:PIZANO-BALATOVIS, MARIA ELENA (MS; RD; LDN; CDE)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ELENA
Last Name:PIZANO-BALATOVIS
Suffix:
Gender:F
Credentials:MS; RD; LDN; CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19871 NW 64TH COURT RD
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2164
Mailing Address - Country:US
Mailing Address - Phone:305-625-7636
Mailing Address - Fax:
Practice Address - Street 1:19871 NW 64TH COURT RD
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2164
Practice Address - Country:US
Practice Address - Phone:305-625-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND1862133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered