Provider Demographics
NPI:1851389076
Name:BALBUENA HEATH, CHARLES FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FREDERICK
Last Name:BALBUENA HEATH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1302 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-5042
Mailing Address - Country:US
Mailing Address - Phone:386-328-0108
Mailing Address - Fax:386-325-1086
Practice Address - Street 1:1305 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043-2547
Practice Address - Country:US
Practice Address - Phone:787-644-1472
Practice Address - Fax:866-412-8287
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2023-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR16184208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice