Ballantyne, Mario Deon

Ballantyne, Mario Deon is an sole proprietor health care provider with primary practice located at 3945 Rose Of Sharon Dr , Orlando FL 32808-2738. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Driver, Transportation Services / Transportation Broker. Transportation Services / Transportation Broker is his primary health care specialty. Ballantyne, Mario Deon can be contacted via phone (321) 279-1218.

Contact Information

Primary practice address
3945 Rose Of Sharon Dr Orlando FL 32808-2738
Phone: (321) 279-1218
Fax: (407) 704-4464
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X B453544754290 Florida
Transportation Services / Transportation Broker 347E00000X B453544754290 Florida

Profile Details

NPI number 1770008914
LBN Legal business name Ballantyne, Mario Deon
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2017
Last updated Jul 21st, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770008914 NPPES
Florida Other 81-0683776 IRS

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