Individual
CHRISTIAN BALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13902 N DALE MABRY HWY STE 219, TAMPA, FL 33618-2424
(813) 830-3235
(813) 409-3852
Mailing address
11202 MONDALE AVE, SEFFNER, FL 33584-7312
(813) 830-3235
(813) 409-3852
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCMS.0102634
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113465300
—
FL
Enumeration date
07/11/2019
Last updated
12/01/2023
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