Active NPI
Brent Ralph Baldasare
- Chiropractor
- Orlando, FL
National Provider Identifier
1871647669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH7682
- Practice address
- 779 N Alafaya TRL
Orlando, FL 32828-7047 - Phone
- (407) 381-4040
- Fax
- (321) 234-9296
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH7682 | FL | Primary |
Addresses
Primary practice location
779 N Alafaya TRL
Orlando, FL 32828-7047
Mailing address
779 N Alafaya TRL
Orlando, FL 32828-7047
Phone (407) 381-4040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101014000992 | FL | Practitioner - Chiropractic | 9830381425 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1871647669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "779 N ALAFAYA TRL",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328287047",
"telephone_number": "407-381-4040",
"fax_number": "321-234-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "779 N ALAFAYA TRL",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328287047",
"telephone_number": "407-381-4040",
"fax_number": "321-234-9296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDASARE",
"first_name": "BRENT",
"middle_name": "RALPH",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH7682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.