Provider Demographics
NPI:1427304856
Name:BATTO
Entity type:Organization
Organization Name:BATTO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:MAHALAH LOUSE UNDINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BATTO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN
Authorized Official - Phone:954-275-0607
Mailing Address - Street 1:4023 NW 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 W OKLAND PARK
Practice Address - Street 2:5305
Practice Address - City:FORT LAUDERDLE
Practice Address - State:FL
Practice Address - Zip Code:33310-5305
Practice Address - Country:US
Practice Address - Phone:954-275-0607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9257932261Q00000X, 281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center