MEDICARE: THOMAS C BALSHI MD PA

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	207NS0135X	Procedural Dermatology Physician	ME88514	FL

General Provider Information

NPI Number	:	1861628547
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS C BALSHI MD PA

Provider Business Mailing Address
First Line	:	4665 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3800
Country	:	US
Telephone Number	:	561-272-6000
Fax Number	:	561-272-2629

Provider Business Practice Location Address
First Line	:	4665 W ATLANTIC AVE
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3800
Country	:	US
Telephone Number	:	561-272-6000
Fax Number	:	561-272-2629

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THOMAS BALSHI
Credential	:	MD
Telephone Number	:	561-272-6000

Provider Enumeration Date	:	06/08/2009
Last Update Date	:	11/25/2014

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