DR. EDWIN BALLELOS (NPI# 1184679151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184679151 |
| Entity Type | Individual |
| Full Name | DR. EDWIN BALLELOS |
| Credential | M.D. |
| Practice Address |
4101 Town Ctr Blvd Orlando FL 32837-5846 |
| Mailing Address |
Po Box 191 Rockland DE 19732-0191 |
| Practice Telephone | 4078503497 |
| Practice Fax Number | 4078510421 |
| Mailing Telephone | 3026514488 |
| Mailing Fax Number | 3026514945 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2014-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME0076442 | FL | Other Service Providers |
| Y | 208000000X | Pediatrics | ME76442 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008475100 | 05 |
| Street Address |
4101 TOWN CTR BLVD |
| City | ORLANDO |
| State | FL |
| Zip Code | 32837-5846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578518130 | Pamela Beach-reber | Specialist | 4101 Town Ctr Blvd, Orlando, FL 32837-5846 | 2006-05-23 |
| 1437250917 | Samuel S Divaker | Pediatrics | 4101 Town Ctr Blvd, Nemours Childrens Urgent Care, Orlando, FL 32837-5846 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194214684 | Advance Obgyn of Central Florida | Obstetrics & Gynecology | 4170 Town Ctr Blvd Ste 104, Orlando, FL 32837 | 2018-05-09 |
| 1881124543 | Shivonne Champatsingh | Respiratory Therapist, Registered | 2730 Rolling Broak Drive, Orlando, FL 32837 | 2017-06-15 |
| 1881133858 | Peter Connole | Specialist/Technologist | 11066 Crystal Glen Blvd, Orlando, FL 32837 | 2017-02-23 |
| 1154779023 | Lemille Ruiz | Case Manager/Care Coordinator | 12925 Lslamorada Dr, Orlando, FL 32837 | 2016-06-01 |
| 1952776650 | Maryolys Rojas | Case Management | 2875 Woodruff Dr, Orlando, FL 32837 | 2015-12-07 |
| 1407230998 | Isis Cancel | Case Manager/Care Coordinator | 1136 Courtney Chase Circle, Apt 711, Orlando, FL 32837 | 2015-07-14 |
| 1306242771 | Robin Mcdonough | Counselor | 11020 Regency Commons Ct, Orlando, FL 32837 | 2014-11-13 |
| 1952720484 | Monisha Louis | Physical Therapist | 4445 Gywndale Ct., Orlando, FL 32837 | 2014-04-11 |
| 1194141028 | Florida Em-i Medical Services, Pa | Physician Assistant | 12100 South John Young Parkway, Orlando, FL 32837 | 2014-03-17 |
| 1366871394 | Isse Song Pa | Dentist | 12554 S John Young Parkway, 104, Orlando Florida, FL 32837 | 2013-11-12 |
| Find all providers in zip 32837 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329355 | Brittani Newport | Pediatrics | 10743 Narcoossee Rd Ste A13, Orlando, FL 32832-6946 | 2020-02-24 |
| 1467091959 | Jennifer Dolcater Ketchersid | Pediatrics | 2501 N Orange Ave Ste 586, Orlando, FL 32804-4603 | 2019-12-31 |
| 1396250098 | Advanced Kid's Care | Pediatrics | 98 Terra Mango Loop, Unit 12, Orlando, FL 32835 | 2017-12-05 |
| 1467977454 | Physician Associates LLC | Pediatrics | 14065 Town Loop Blvd Ste 300, Orlando, FL 32837-6199 | 2017-08-10 |
| 1609320837 | Starus Pediatrics LLC | Pediatrics | 6001 Vineland Rd Ste 103, Orlando, FL 32819-7829 | 2016-08-04 |
| 1942656517 | Vijay Mehta | Pediatrics | 60 W Gore St # Mp373, Orlando, FL 32806 | 2016-05-12 |
| 1124401674 | Kelsey Wehrenberg | Pediatrics | 83 Columbia St Ste 202, Orlando, FL 32806 | 2015-07-01 |
| 1396138319 | Premier Physician Associates LLC | Pediatrics | 13651 Hunters Oak Dr, Ste 101, Orlando, FL 32837-7679 | 2015-03-16 |
| 1073917076 | Abdollah Iravani Md Pa | Pediatrics | 2106 N Orange Ave # 100, Orlando, FL 32804-5535 | 2014-10-20 |
| 1720407620 | Christopher Dudek | Pediatrics | 86 W Underwood St Ste 200, Orlando, FL 32806-1110 | 2014-04-08 |
| Find all providers in ORLANDO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.