Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | DN19703 | FL |
Y | 1223G0001X | General Practice | 34727 | TX |
Y | 213EG0000X | General Practice | 34727 | TX |
N | 1223G0001X | General Practice | DN19703 | FL |
N | 213EG0000X | General Practice | DN19703 | FL |
NPI | 1346596509 |
---|---|
Provider Name | Dr. Rondre Florant Baluyot |
First Address | Jbsa Lackland, TX 78236-5313 |
Second Address | Jbsa Lackland, TX 78236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2012 |
Last Update Date | 31/01/2021 |