Individual
DR. GERARDO BALDASSARRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
98 NOCATEE VILLAGE DR, PONTE VEDRA, FL 32081-6152
(904) 202-4243
(904) 202-4639
Mailing address
PO BOX 746636, ATLANTA, GA 30374-6636
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME92921
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275504581
TRICARE
FL
01
—
16636
BCBS
FL
05
—
273061800
—
FL
Enumeration date
01/27/2006
Last updated
01/10/2023
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