Jean Fritzner Balan, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ACN862 Issued in FL

Practice address

305 W Central Ave
Lake Wales, FL 33853-4015

Phone

(866) 234-8534

NPI assigned

Oct 16, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jean.balan.1@12125.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Frostproof, FL
  • NPI 1467449660

  FL

  Medicare reassignment NPD
• Doctor Today TLC, LLC

  • Primary Care Clinic/Center
  • Lakeland, FL
  • NPI 1669400347

  FL

  Medicare reassignment NPD
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Bartow, FL
  • NPI 1811796469
  NPD
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Winter Haven, FL
  • NPI 1699134924
  NPD
• Central Florida Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Winter Haven, FL
  • NPI 1467752998
  NPD (past)
• Central Florida Health Care Inc

  • Multi-Specialty Clinic/Center
  • Wauchula, FL
  • NPI 1811156672
  NPD (past)
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Bartow, FL
  • NPI 1407615826
  NPD (past)
• Central Florida Health Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Avon Park, FL
  • NPI 1831232669

  Family Medicine

  NPD (past)
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dundee, FL
  • NPI 1063408813
  NPD (past)
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Avon Park, FL
  • NPI 1063409290

  General Practice

  NPD (past)
• Central Florida Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeland, FL
  • NPI 1386835064
  NPD (past)
• Central Florida Health Care, Inc.

  • Multi-Specialty Clinic/Center
  • Dundee, FL
  • NPI 1720247588
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1124499173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W CENTRAL AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534015",
            "telephone_number": "866-234-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALAN",
        "first_name": "JEAN",
        "middle_name": "FRITZNER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-16",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "018801",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ACN862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mariam Baez, CCC-SLP
• Bangash Dentistry PLLC
• Maryam Bangash
• Santelia Barnes
• Heather Watson Barranco
• Ricardo Jesus Barranon, MD

• All providers in Lake Wales, FL
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.