| Ballout International Llc | |
|
1931 19th Pl Vero Beach FL 32960-3555 | |
| (313) 574-2965 | |
| (702) 441-2580 |
| Full Name | Ballout International Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1931 19th Pl, Vero Beach, Florida |
| Authorized Official Name and Position | Hussien Ballout (OWNER) |
| Authorized Official Contact | 3135742965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ballout International Llc 1931 19th Pl Vero Beach FL 32960-3555 Ph: (313) 574-2965 | Ballout International Llc 1931 19th Pl Vero Beach FL 32960-3555 Ph: (313) 574-2965 |
| NPI Number | 1629554225 |
|---|---|
| Provider Enumeration Date | 07/17/2018 |
| Last Update Date | 09/18/2024 |
| Medicare PECOS PAC ID | 5890045256 |
|---|---|
| Medicare Enrollment ID | O20180905001883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629554225 | NPI | - | NPPES |
| JL435A | Other | FL | MEDICARE PTAN |
| 100849400 | Medicaid | FL | |
| DY5252 | Other | FL | RRMEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Paige M Ahammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407073943 PECOS PAC ID: 3476627936 Enrollment ID: I20080731000418 |
| Provider Name | Luke Carter Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366702441 PECOS PAC ID: 1951567767 Enrollment ID: I20151104001994 |
| Provider Name | Seema K Patel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235127671 PECOS PAC ID: 2163497967 Enrollment ID: I20161114002358 |
| Provider Name | Hussien Abbasse Ballout |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376955682 PECOS PAC ID: 0042504318 Enrollment ID: I20170802003319 |
| Provider Name | Jawad Ahmad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639597115 PECOS PAC ID: 7416177910 Enrollment ID: I20171110001836 |
| Provider Name | Toya Ann Alder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255819157 PECOS PAC ID: 4486906633 Enrollment ID: I20181016002830 |
| Provider Name | Ingrid A Lovelace-joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811404866 PECOS PAC ID: 0042555203 Enrollment ID: I20181218000133 |
| Provider Name | Carlos E Orive |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922585975 PECOS PAC ID: 2668405838 Enrollment ID: I20190208001789 |
| Provider Name | Luis Daniel Correa Luna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497721641 PECOS PAC ID: 9638112618 Enrollment ID: I20190212000657 |
| Provider Name | Daniel A Reikher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881048445 PECOS PAC ID: 3870836786 Enrollment ID: I20190516001815 |
| Provider Name | Jonathan Alexander Quinonez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679013437 PECOS PAC ID: 7315206877 Enrollment ID: I20191125000971 |
| Provider Name | Robert Mathew Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548808439 PECOS PAC ID: 0749615664 Enrollment ID: I20200122002124 |
| Provider Name | Ellena Lois Boddie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689673790 PECOS PAC ID: 0840399515 Enrollment ID: I20201105001302 |
| Provider Name | Gilberto Alvarez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598303984 PECOS PAC ID: 8224449608 Enrollment ID: I20201117000779 |
| Provider Name | Juliette Powell Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386301299 PECOS PAC ID: 4082001482 Enrollment ID: I20220504001685 |
| Provider Name | Robert H Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265923841 PECOS PAC ID: 0446637524 Enrollment ID: I20220510002552 |
| Provider Name | Gelineau Puna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992402572 PECOS PAC ID: 1355716895 Enrollment ID: I20230413002900 |
| Provider Name | Tamelia D Lakraj-edwards |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1114367802 PECOS PAC ID: 9032353230 Enrollment ID: I20230831000837 |
| Provider Name | Caitlyn Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962284281 PECOS PAC ID: 7315397007 Enrollment ID: I20231220004071 |
| Provider Name | Robert Ernst Milici |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922882208 PECOS PAC ID: 5991157562 Enrollment ID: I20240118004022 |
| Provider Name | Patricia Siatta Tulay-robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780927772 PECOS PAC ID: 2062864663 Enrollment ID: I20240119000430 |
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