Individual
DR. MICHAEL BAHLATZIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
524 W SAGAMORE AVE, CLEWISTON, FL 33440-3514
(863) 902-3032
Mailing address
9723 BLUE STONE CIR, FORT MYERS, FL 33913-6722
(607) 215-3887
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4569
FL
213ES0131X
Foot Surgery Podiatrist
004310
NY
363AS0400X
Surgical Physician Assistant
PA9115963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01039909
—
NY
Enumeration date
04/01/2006
Last updated
02/27/2025
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