| Balanced Physician Care Pa | |
|
115 Professional Park Drive Suite 104 Ponte Vedra Beach FL 32082 | |
| (904) 930-4774 | |
| Not Available |
| Full Name | Balanced Physician Care Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 115 Professional Park Drive, Ponte Vedra Beach, Florida |
| Authorized Official Name and Position | Sharyl J Truty (PROVIDER/PRESIDENT) |
| Authorized Official Contact | 9049304774 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Balanced Physician Care Pa 115 Professional Park Drive Suite 104 Ponte Vedra Beach FL 32082 Ph: (904) 930-4774 | Balanced Physician Care Pa 115 Professional Park Drive Suite 104 Ponte Vedra Beach FL 32082 Ph: (904) 930-4774 |
| NPI Number | 1033575121 |
|---|---|
| Provider Enumeration Date | 01/06/2016 |
| Last Update Date | 01/06/2016 |
| Medicare PECOS PAC ID | 5395041438 |
|---|---|
| Medicare Enrollment ID | O20160315002814 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033575121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sharyl J Truty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093767147 PECOS PAC ID: 2567456544 Enrollment ID: I20051107000835 |
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