MEDICARE: GEORGE P BALIS MD

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	207X00000X	Orthopaedic Surgery Physician	D0023376	MD
2	207X00000X	Orthopaedic Surgery Physician	35043193	OH
3	207X00000X	Orthopaedic Surgery Physician	ME143456	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1790748630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE P BALIS MD

Provider Business Mailing Address
First Line	:	3066 SW MARTIN DOWNS BLVD STE E
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-2683
Country	:	US
Telephone Number	:	772-781-2735
Fax Number	:	772-781-2739

Provider Business Practice Location Address
First Line	:	3066 SW MARTIN DOWNS BLVD STE E
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-2683
Country	:	US
Telephone Number	:	772-781-2735
Fax Number	:	772-781-2739

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	07/20/2020

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Directions to “ GEORGE P BALIS MD” Practice Location

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