MEDICARE: HAYLEY R BALMER

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	363A00000X	Physician Assistant	PA9119995	FL

General Provider Information

NPI Number	:	1487442182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAYLEY R BALMER

Provider Business Mailing Address
First Line	:	661 E ALTAMONTE DR STE 222
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5102
Country	:	US
Telephone Number	:	407-303-3081
Fax Number	:	407-303-2147

Provider Business Practice Location Address
First Line	:	661 E ALTAMONTE DR STE 222
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5102
Country	:	US
Telephone Number	:	407-303-3081
Fax Number	:

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

Provider Enumeration Date	:	04/30/2025
Last Update Date	:	02/08/2026

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Directions to “ HAYLEY R BALMER ” Practice Location

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