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NPI Code Detail

MEDICARE: DAVID ALEXANDER BALLETTI

MEDICARE: DAVID ALEXANDER BALLETTI
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
1225X00000XOccupational TherapistOT22047FL

Other Identifiers

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

General Provider Information

NPI Number : 1750791620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ALEXANDER BALLETTI
Provider Business Mailing Address
First Line : 8901 SW 69TH ST
Second Line :
City : MIAMI
State : FL
Zip : 33173-2446
Country : US
Telephone Number : 305-484-4004
Fax Number :
Provider Business Practice Location Address
First Line : 107 ANTILLA AVE
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-3301
Country : US
Telephone Number : 305-567-5881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2014
Last Update Date : 03/06/2023

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Directions to “ DAVID ALEXANDER BALLETTI ” Practice Location

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