Provider Demographics
NPI:1194967851
Name:BALLIU, ERJOLA (MD)
Entity type:Individual
Prefix:
First Name:ERJOLA
Middle Name:
Last Name:BALLIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERJOLA
Other - Middle Name:
Other - Last Name:SHEHU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1324 LAKELAND HILLS BLVD.
Mailing Address - Street 2:ATTN: MANAGED CARE DEPT.
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3030 HARDEN BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-7952
Practice Address - Country:US
Practice Address - Phone:863-284-6800
Practice Address - Fax:863-284-6825
Is Sole Proprietor?:No
Enumeration Date:2009-03-27
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1183362080P0205X
FLME118336207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology