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NPI Code Detail

MEDICARE: CATHERINE SELLERS BALL D.M.D

MEDICARE: CATHERINE SELLERS BALL D.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
11223G0001XGeneral Practice DentistryDN19154FL

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 : 1528371366
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE SELLERS BALL D.M.D
Provider Business Mailing Address
First Line : 6170 VALERIAN BLVD
Second Line :
City : ORLANDO
State : FL
Zip : 32819-4562
Country : US
Telephone Number : 770-289-1635
Fax Number :
Provider Business Practice Location Address
First Line : 2050 OLD HICKORY TREE RD
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34772-8926
Country : US
Telephone Number : 407-556-3969
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2010
Last Update Date : 07/21/2010

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