Individual
LAITH ADLI AL BALBISSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7236 STONEROCK CIR, ORLANDO, FL 32819-8000
(321) 841-6444
(407) 370-5820
Mailing address
7236 STONEROCK CIR, ORLANDO, FL 32819-8000
(321) 841-6444
(407) 370-5820
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Q5612
TX
2086S0129X
Vascular Surgery Physician
Primary
ME145283
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106291400
—
FL
05
—
200606530 A
—
OK
05
—
352164301
—
TX
05
—
352164302
—
TX
05
—
63075211
—
NM
Enumeration date
07/16/2008
Last updated
08/13/2020
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