Healthcare Provider Details

I. General information

NPI: 1578494878
Provider Name (Legal Business Name): LUIS FRANCISCO BALLADARES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10820 KENWOOD RD
BLUE ASH OH
45242-2812
US

IV. Provider business mailing address

4064 BEECHWOOD AVE
CINCINNATI OH
45229-1410
US

V. Phone/Fax

Practice location:
  • Phone: 786-246-9933
  • Fax:
Mailing address:
  • Phone: 786-246-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: