Provider Demographics
NPI:1720232903
Name:MANUEL A BATLLE MD PA
Entity Type:Organization
Organization Name:MANUEL A BATLLE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:ARTURO
Authorized Official - Last Name:BATLLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-304-1115
Mailing Address - Street 1:130 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6224
Mailing Address - Country:US
Mailing Address - Phone:239-304-1115
Mailing Address - Fax:239-263-1119
Practice Address - Street 1:130 TAMIAMI TRL N
Practice Address - Street 2:SUITE 110
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6224
Practice Address - Country:US
Practice Address - Phone:239-304-1115
Practice Address - Fax:239-263-1119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME103035OtherSTATE OF FLORIDA BOARD OF MEDICINE