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
Phone: (772) 794-7400
Fax: (772) 794-7453
Website:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164625935 | NPPES |
| Florida | MEDICAID | 000551400 |
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