NPI 1770008914

Mario Deon Ballantyne

Practitioner Transportation Broker Orlando, FL

Practice location

Address: 3945 Rose of Sharon Dr, Orlando, FL 32808-2738
Phone: (321) 279-1218
Fax: (407) 704-4464

Registered specialties (2)

Transportation Broker Primary

Transportation Services Taxonomy 347E00000X Licence B453544754290 (FL)

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Driver

Other Service Providers Taxonomy 172A00000X Licence B453544754290 (FL)

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Registry record

NPI: 1770008914
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2017
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.