Individual
JACOB TYLER BALKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11300 NE 2ND AVE, MIAMI SHORES, FL 33161-6628
(305) 899-3000
Mailing address
6181 SE 11TH ST, OCALA, FL 34472-7862
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9486538
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11039828
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/02/2023
Last updated
08/15/2025
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