MEDICARE: ERJOLA BALLIU M.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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME118336	FL
2	2080P0205X	Pediatric Endocrinology Physician	118336	FL

General Provider Information

NPI Number	:	1194967851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERJOLA BALLIU M.D.

Provider Business Mailing Address
First Line	:	2111 W SWANN AVE STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2478
Country	:	US
Telephone Number	:	813-428-8606
Fax Number	:	813-428-8621

Provider Business Practice Location Address
First Line	:	2111 W SWANN AVE STE 204
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2478
Country	:	US
Telephone Number	:	813-428-8606
Fax Number	:	813-428-8621

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

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	03/05/2026

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