Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME118336 | FL |
N | 2080P0205X | Pediatric Endocrinologist | 118336 | FL |
NPI | 1194967851 |
---|---|
Provider Name | Erjola Balliu |
First Address | Lakeland, FL 33805 |
Second Address | Lakeland, FL 33803-3818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2009 |
Last Update Date | 17/03/2018 |