Individual
RALPH E BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
237 FERNWOOD BLVD, FERN PARK, FL 32730-2116
(407) 831-2411
(407) 831-0195
Mailing address
1840 LAKE EMMA RD, LONGWOOD, FL 32750-7137
(321) 695-0157
(407) 682-4405
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME17742
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280555300
—
FL
Enumeration date
02/26/2007
Last updated
04/07/2011
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