Provider Demographics
NPI:1992786503
Name:BALDARI, DUCCIO (MD)
Entity type:Individual
Prefix:
First Name:DUCCIO
Middle Name:
Last Name:BALDARI
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:PO BOX 939
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-0939
Mailing Address - Country:US
Mailing Address - Phone:561-793-6100
Mailing Address - Fax:561-793-1974
Practice Address - Street 1:3347 STATE ROAD 7
Practice Address - Street 2:STE. 203
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8095
Practice Address - Country:US
Practice Address - Phone:561-793-6100
Practice Address - Fax:561-793-1974
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237609207RC0000X
FLME105814207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002834300Medicaid
FLDE755ZMedicare Oscar/Certification
FL002834300Medicaid