Balthazar, Witni

Balthazar, Witni is an sole proprietor health care provider with primary practice located at 1900 27Th St , Vero Beach FL 32960-3383. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Balthazar, Witni can be contacted via phone (772) 794-7400.

Contact Information

Primary practice address
1900 27Th St Vero Beach FL 32960-3383
Fax: (772) 794-7453
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X ACN280 Florida

Profile Details

NPI number 1164625935
LBN Legal business name Balthazar, Witni
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 7th, 2007
Last updated Aug 25th, 2014 - about 10 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 1164625935 NPPES
Florida MEDICAID 000551400

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