Individual
KENNETH BALLOQUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6284 E 5TH AVE, HIALEAH, FL 33013-1114
(786) 562-9787
Mailing address
6284 E 5TH AVE, HIALEAH, FL 33013-1114
(786) 562-9787
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29864
FL
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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