Individual
BALEBAIL ASHOK RAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4001 E FLETCHER AVE, TAMPA, FL 33613-4808
(813) 866-1611
(813) 866-1612
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME31300
FL
2084P0805X
Geriatric Psychiatry Physician
ME 31300
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038863700
—
FL
Enumeration date
02/08/2007
Last updated
09/15/2009
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