Jeroen Balledux MD LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME109148 Issued in FL

Legal business name

JEROEN BALLEDUX MD LLC

Practice address

1447 Medical Park Blvd
Suite 101
Wellington, FL 33414-3164

Phone

(561) 844-0120

Fax

(561) 800-1074

NPI assigned

Feb 24, 2012

Organization subpart

No

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

Authorized official

Name

Miss Anjali Moorjani, MBA

Title

Operational Practice Manager

Phone

(561) 844-0120

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1639443534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD",
            "address_2": "SUITE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-844-0120",
            "fax_number": "561-800-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 MEDICAL PARK BLVD",
            "address_2": "SUITE 101",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143164",
            "telephone_number": "561-844-0120",
            "fax_number": "561-800-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROEN BALLEDUX MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "MOORJANI",
        "authorized_official_first_name": "ANJALI",
        "authorized_official_title_or_position": "OPERATIONAL PRACTICE MANAGER",
        "authorized_official_telephone_number": "561-844-0120",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME109148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in Wellington, FL
• Providers in Wellington, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.