Provider Demographics
NPI:1134320229
Name:BALAN, ALEJANDRO (PTA)
Entity Type:Individual
Prefix:MR
First Name:ALEJANDRO
Middle Name:
Last Name:BALAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 222
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4470
Mailing Address - Country:US
Mailing Address - Phone:239-649-8001
Mailing Address - Fax:239-649-8003
Practice Address - Street 1:2500 TAMIAMI TRL N
Practice Address - Street 2:SUITE 222
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4470
Practice Address - Country:US
Practice Address - Phone:239-649-8001
Practice Address - Fax:239-649-8003
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 18846225200000X
FLMA 35157225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist