# BALB UC MED LLC

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

## Provider details

- **NPI number:** 1942969373
- **Authorized official:** ELY RAZ (CEO)
- **Authorized official phone:** (804) 767-1288

## Contact information

- **Practice address:** 3901 NW 79TH AVE STE 245, DORAL, FL 33166-6506
- **Practice address phone:** (804) 767-1288
- **Practice address fax:** (916) 299-9941
- **Mailing address:** 3901 NW 79TH AVE STE 245, DORAL, FL 33166-6506
- **Mailing address phone:** (804) 767-1288
- **Mailing address fax:** (916) 299-9941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/13/2021
- **Last updated:** 12/13/2021