Individual
VICTOR A BALTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4000 N HIGHWAY A1A PH 2, FORT PIERCE, FL 34949-8530
(772) 359-9529
Mailing address
4000 N HIGHWAY A1A PH 2, FORT PIERCE, FL 34949-8530
(772) 359-9529
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME83027
FL
2084P0800X
Psychiatry Physician
Primary
ME 83027
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265998100
—
FL
01
—
62795
BLUE CROSS
FL
Enumeration date
03/17/2006
Last updated
03/08/2012
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