Evaristo Placedes Badiola, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME0047939 Issued in FL

Practice address

204 Lake Harris Dr
Lakeland, FL 33813-2632

Phone

(863) 646-7733

Fax

(863) 647-2648

NPI assigned

May 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1841246873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 LAKE HARRIS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132632",
            "telephone_number": "863-646-7733",
            "fax_number": "863-647-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 LAKE HARRIS DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132632",
            "telephone_number": "863-646-7733",
            "fax_number": "863-647-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADIOLA",
        "first_name": "EVARISTO",
        "middle_name": "PLACEDES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0047939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Bachelder
• Bernard Patopaten Bachoco, RPT
• Sarah L Back, APRN
• Michelle Hope Bacon, APRN
• Sami K Baddoura, M.D.
• Juan A Baez Gonzalez, MD
• Walver Baez Mejias, MD
• Yamira Marie Baez, APRN
• Edward Baffoe-Bonnie, MD
• Ignatius Henry Baffoe-Bonnie, M.D.

• All providers in Lakeland, FL
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.