Dylan Jordan Baltar

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

31008 Issued in FL

Practice address

430 NE 10TH St
Gainesville, FL 32601-5688

Phone

(954) 496-3110

NPI assigned

May 25, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1851966535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 NE 10TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326015688",
            "telephone_number": "954-496-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 NE 10TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326015688",
            "telephone_number": "954-496-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAR",
        "first_name": "DYLAN",
        "middle_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "31008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Gainesville",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "430 NE 10th St",
            "city": "Gainesville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "326015688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vicky J Ballard
• Briana Ballister, PHARMD
• Jillian Ballister, DNP, APRN, PMHNP-BC
• Bernard H Ballou, MD
• Kalyani Nagaraj Ballur
• Caroline Baltrucki, OT
• Katherine Elizabeth Baltzelle
• Marvin R Balza
• Elizabeth Bamiro
• Genevieve Banaag

• Physical Therapy Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.