Balb UC Med LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

BALB UC MED LLC

Practice address

3901 NW 79TH Ave Ste 245
Doral, FL 33166-6506

Phone

(804) 767-1288

Fax

(916) 299-9941

NPI assigned

Dec 13, 2021

Organization subpart

No

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

Authorized official

Name

Ely Raz

Title

Ceo

Phone

(804) 767-1288

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1942969373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 NW 79TH AVE STE 245",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666506",
            "telephone_number": "804-767-1288",
            "fax_number": "916-299-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 NW 79TH AVE STE 245",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331666506",
            "telephone_number": "804-767-1288",
            "fax_number": "916-299-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALB UC MED LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "RAZ",
        "authorized_official_first_name": "ELY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-767-1288"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Badlissi
• Maylan Baez Delgado
• Addharossie Chary Baez
• Stephen Paul Bajdo, R.N.
• Jasmine Baker
• Micaela Baldivieso
• Balleza Scholtz Inc
• Ruben Balmaceda
• Shauna Balmaceda
• Ana Soavia Balsano

• Urgent Care Clinic/Center in Doral, FL
• Providers in Doral, FL by specialty
• Urgent Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.