Balaji, Gobivenkata

Balaji, Gobivenkata is an individual health care provider with primary practice located at 298 Michigan Ave Suite 101, Melbourne FL 32901-3104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Balaji, Gobivenkata can be contacted via phone (321) 215-6899.

Contact Information

Primary practice address
298 Michigan Ave Suite 101 Melbourne FL 32901-3104
Phone: (321) 215-6899
Fax: (321) 215-6789
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME77839 Florida

Profile Details

NPI number 1649230459
LBN Legal business name Balaji, Gobivenkata
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Mar 1st, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649230459 NPPES
Florida MEDICAID 257850600
Florida Other 110199177

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