| Dr Brent Ralph Baldasare, | |
|
779 N Alafaya Trl, Orlando, FL 32828-7047 | |
| (407) 381-4040 | |
| (321) 234-9296 |
| Full Name | Dr Brent Ralph Baldasare |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 779 N Alafaya Trl, Orlando, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871647669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CH7682 (Florida) | Primary |
| Provider Name | Affinity Healthcare Center At Waterford Lakes Pl |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1700058534 PECOS PAC ID: 6305038993 Enrollment ID: O20101014000954 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Brent Ralph Baldasare, 779 N Alafaya Trl, Orlando, FL 32828-7047 Ph: (407) 381-4040 | Dr Brent Ralph Baldasare, 779 N Alafaya Trl, Orlando, FL 32828-7047 Ph: (407) 381-4040 |
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