# COLLIER REGIONAL ORTHOPAEDIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013046085
- **Authorized official:** JEFFREY E BALAZSY MD (PRESIDENT)
- **Authorized official phone:** (239) 393-0030

## Contact information

- **Practice address:** 950 N COLLIER BLVD, SUITE 304, MARCO ISLAND, FL 34145-2725
- **Practice address phone:** (239) 393-0030
- **Practice address fax:** (239) 394-6879
- **Mailing address:** PO BOX 22958, CLEVELAND, OH 44122-0958
- **Mailing address phone:** (216) 595-9600
- **Mailing address fax:** (216) 595-9601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME92348 | FL | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 09/27/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4303052 | — | MI |
| 01 | — | 91108 | BCBS OF FLORIDA | FL |
| 01 | — | ME92348 | MEDICAL LICENSE | FL |