MEDICARE: DR. EMILIO H. BALIUS O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OP0002485	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619978509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILIO H. BALIUS O.D.

Provider Business Mailing Address
First Line	:	1097 S LE JEUNE RD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2639
Country	:	US
Telephone Number	:	305-442-2021
Fax Number	:	305-442-1498

Provider Business Practice Location Address
First Line	:	1097 S LE JEUNE RD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2639
Country	:	US
Telephone Number	:	305-442-2021
Fax Number	:	305-442-1498

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/19/2024

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