Mario Deon Ballantyne

Primary specialty

Transportation BrokerTaxonomy code 347E00000X

License

B453544754290 Issued in FL

Practice address

3945 Rose of Sharon Dr
Orlando, FL 32808-2738

Phone

(321) 279-1218

Fax

(407) 704-4464

NPI assigned

Aug 9, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medtransit LLC

  • Non-emergency Medical Transport (VAN)
  • Orlando, FL
  • NPI 1538632153
  NPD Authorized official
• Vital Transit LLC

  • Non-emergency Medical Transport (VAN)
  • Baltimore, MD
  • NPI 1922956978
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770008914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3945 ROSE OF SHARON DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328082738",
            "telephone_number": "321-279-1218",
            "fax_number": "407-704-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 ROSE OF SHARON DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328082738",
            "telephone_number": "321-279-1218",
            "fax_number": "407-704-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLANTYNE",
        "first_name": "MARIO",
        "middle_name": "DEON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Driver",
            "state": "FL",
            "license": "B453544754290",
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "FL",
            "license": "B453544754290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "81-0683776",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cutrena Ball
• Janet Renee Balla
• Devyani M Balladin
• Frances Ballagas, D.M.D.
• Tammy Lynn Ballant, ARNP
• Victoria Jacqueline Ballard
• Edwin Ballelos, M.D.
• Nikki Anne M. Ballelos
• Richard A Ballentine
• Sarah Baller, ATC, LAT, CES

• Transportation Broker in Orlando, FL
• Providers in Orlando, FL by specialty
• Transportation Broker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.