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General NPI Number Information
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NPI Number | 1134320229
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Entity Type | Individual
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Provider Name | ALEJANDRO BALAN PTA
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 11/08/2007
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Provider Practice Location Address
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Address Line | 2500 TAMIAMI TRL N SUITE 222
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City | NAPLES
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State | FL
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Zip | 34103-4470
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Country | US
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Telephone | 239-649-8001
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Fax | 239-649-8003
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Provider Business Mailing Address
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Address Line | 2500 TAMIAMI TRL N SUITE 222
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City | NAPLES
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State | FL
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Zip | 34103-4470
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Country | US
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Telephone | 239-649-8001
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Fax | 239-649-8003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA 18846
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 35157
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License Number State | FL
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