Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME 52894 | FL |
NPI | 1063432540 |
---|---|
Provider Name | Dr. Claudia B Balducci |
First Address | Tampa, FL 33618-8626 |
Second Address | Tampa, FL 33612-4745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) |