Healthcare Provider Details

I. General information

NPI: 1144228362
Provider Name (Legal Business Name): DAVID ROBERT BALDINGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14171 METROPOLIS AVE STE 101
FORT MYERS FL
33912-4335
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 239-320-8140
  • Fax: 239-320-8141
Mailing address:
  • Phone: 877-856-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME51144
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: