Gda Blalance Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

GDA BLALANCE MEDICAL LLC

Practice address

4349 18TH PL SW
Naples, FL 34116-5917

Phone

(239) 692-2630

NPI assigned

Nov 8, 2023

Last updated

Nov 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leonardo Mastache, APRNNPI 1104699297

Title

President

Phone

(239) 692-2630

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leonardo Mastache, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Naples, FL
  • NPI 1104699297

  Family

  NPD Authorized official

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1720852007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4349 18TH PL SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165917",
            "telephone_number": "239-692-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4349 18TH PL SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165917",
            "telephone_number": "239-692-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GDA BLALANCE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "MASTACHE",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-692-2630",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Cathleen Gay, DDS,MDS
• Yanieke Jihan Gayle
• Stacey L Gazan, AGACNP-BC
• Alicia Gazda
• Shai Del Carmen Gazga
• Douglas Mair Gebbie, MD
• Jessica Michelle Gee
• Cameron Gehrke, OTR/L
• Sherry Kathleen Geiger, CRNA
• Bruce A Gelinas, MD

• Family Nurse Practitioner in Naples, FL
• Providers in Naples, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.