Individual
MOHAMMAD ELBALLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3030 HARDEN BLVD, LAKELAND, FL 33803-7952
(863) 687-1222
Mailing address
956 COURT AVE STE H314A, MEMPHIS, TN 38103-2822
(901) 448-5737
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME135268
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2013
Last updated
11/03/2022
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