MEDICARE: ARTURO BALANDRA 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	208800000X	Urology Physician	MT188365	PA
2	208800000X	Urology Physician	ME109228	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00956370	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3298242	OTHER	FL	UNITED HEALTHCARE
3	P959228	OTHER	FL	OPTIMUM
4	P996671	OTHER	FL	FREEDOM
5	6677242	OTHER	FL	CIGNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	14CV6	OTHER	FL	BCBS OF FL
8	9036668	OTHER	FL	AETNA
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982760369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTURO BALANDRA MD

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: MANAGED CARE DEPT.
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:

Provider Business Practice Location Address
First Line	:	26800 S TAMIAMI TRL
Second Line	:	SUITE 250
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-4349
Country	:	US
Telephone Number	:	239-434-8565
Fax Number	:	239-434-8569

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	12/11/2014

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Directions to “ ARTURO BALANDRA MD” Practice Location

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