Organization
COLLIER REGIONAL ORTHOPAEDIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY E BALAZSY MD (PRESIDENT)
(239) 393-0030
Entity
Organization
Contact information
Practice address
950 N COLLIER BLVD, SUITE 304, MARCO ISLAND, FL 34145-2725
(239) 393-0030
(239) 394-6879
Mailing address
PO BOX 22958, CLEVELAND, OH 44122-0958
(216) 595-9600
(216) 595-9601
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME92348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4303052
—
MI
01
—
91108
BCBS OF FLORIDA
FL
01
—
ME92348
MEDICAL LICENSE
FL
Enumeration date
03/05/2007
Last updated
09/27/2007
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