Provider Demographics
NPI:1114001427
Name:BAALHANESS, MEIR MOSHEH (MD)
Entity type:Individual
Prefix:
First Name:MEIR
Middle Name:MOSHEH
Last Name:BAALHANESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W SAMPLE RD STE 320
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-1346
Mailing Address - Country:US
Mailing Address - Phone:561-322-3588
Mailing Address - Fax:754-812-5993
Practice Address - Street 1:2001 W SAMPLE RD STE 320
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-1346
Practice Address - Country:US
Practice Address - Phone:561-322-3588
Practice Address - Fax:754-812-5993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME99890207W00000X, 207WX0107X
CTO45825207W00000X
TXM1482207W00000X
NY225661207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280729700Medicaid
FLAH005YMedicare PIN
FLAH005XMedicare PIN