Individual
RUSSELL PATRICK BALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 444-2200
Mailing address
9268 WEDGEWOOD DR, TAMARAC, FL 33321-3566
(954) 261-5498
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
APRN11041094
FL
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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