MR. KEVIN MICHAEL BLAKE (NPI# 1114032133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114032133 |
| Entity Type | Individual |
| Full Name | MR. KEVIN MICHAEL BLAKE |
| Credential | PHYSICAL THERAPIST |
| Practice Address |
1893 Ne Miami Gardens Dr North Miami Beach FL 33179-5035 |
| Mailing Address |
1251 Ne 108th St Apt. 718 Miami FL 33161-7307 |
| Practice Telephone | 3056820179 |
| Practice Fax Number | 3056820775 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2017-06-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | PT19289 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
PT19289 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215394424 | Kevin Blake | Counselor | 4400 Euclid Ave, Cleveland, OH 44103-3734 | 2016-01-19 |
| 1174957864 | Kevin K Blake | Registered Nurse | 1 Professional Park Dr, Suite 21, Johnson City, TN 37604-6587 | 2013-08-29 |
| Street Address |
1893 NE MIAMI GARDENS DR |
| City | NORTH MIAMI BEACH |
| State | FL |
| Zip Code | 33179-5035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467791780 | Alysia Q Williams | Physical Therapist | 1893 Ne Miami Gardens Dr, North Miami Beach, FL 33179-5035 | 2013-02-06 |
| 1033480603 | Monica L Castano | Occupational Therapy Assistant | 1893 Ne Miami Gardens Dr, North Miami Beach, FL 33179-5035 | 2012-01-13 |
| 1336455435 | Cora | Clinic/Center | 1893 Ne Miami Gardens Dr, North Miami Beach, FL 33179-5035 | 2010-08-26 |
| 1548493471 | Jameson Toussaint | Physical Therapist | 1893 Ne Miami Gardens Dr, North Miami Beach, FL 33179-5035 | 2009-08-26 |
| 1609954163 | Deirdre Hughes | Occupational Therapist | 1893 Ne Miami Gardens Dr, North Miami Beach, FL 33179-5035 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619531365 | Bianca Dorce | Nurse Practitioner | 20036 Ne 2nd Pl, Miami, FL 33179 | 2019-04-29 |
| 1790254027 | Linda Rachel Topel | Family Medicine | 1911 Ne 197 Terrace, North Miami Beach, FL 33179 | 2018-11-15 |
| 1427542356 | Arianne Monal | Assistant Behavior Analyst | 447 Ne 210th Circle Ter Apt 202, Miami, FL 33179 | 2018-06-14 |
| 1588152268 | Carvil's Professional Service | Case Management | 1311 Ne 210 Ter, Miami, FL 33179 | 2018-04-27 |
| 1407363997 | Martha Acosta | Behavioral Analyst | 1160 Ne 214th St, Miami, FL 33179 | 2018-01-05 |
| 1730698697 | Jacqueline Stone | Dietitian, Registered | 1895 Ne 197th Ter, Miami, FL 33179 | 2017-09-23 |
| 1912420647 | Barbara Ann Hunter | Social Worker | 20170 Ne 3 Court Unit 1, Miami, FL 33179 | 2017-07-25 |
| 1356875660 | Germanie Marlene Casanova | Counselor | 1300 Ne 204 Street, Miami, FL 33179 | 2017-04-13 |
| 1164962494 | Lilliana Vazquez-rivera Md LLC | Internal Medicine | 382 Ne 191st St, #74432, Miami, FL 33179 | 2017-03-06 |
| 1437606027 | Marjorie Jadotte | Nurse Practitioner | 20826 San Simeon Way Unit 51 L, North Miami Beach, FL 33179 | 2016-09-01 |
| Find all providers in zip 33179 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679107544 | Erin F Black | Physical Therapist | 2300 Bluff Oak Way Apt 5104, Tallahassee, FL 32311-6129 | 2020-02-28 |
| 1942851225 | Sara Walker | Physical Therapist | 213 S Dillard Street, Suite 320c, Winter Garden, FL 34787 | 2019-09-26 |
| 1235697574 | Promobility Care Physical Therapy LLC | Physical Therapist | 11204 58th Street Cir E, Parrish, FL 34219-4513 | 2019-03-05 |
| 1255821542 | Lacey Smith | Physical Therapist | 5429 Highlands Vista Cir, Lakeland, FL 33812-5216 | 2018-05-13 |
| 1770005720 | Leading Edge Rehabilitation LLC | Physical Therapist | 19348 Wind Dancer St, Lutz, FL 33558-9054 | 2017-07-12 |
| 1558896522 | Emily Routh | Physical Therapist | 6220 Willow Beck Ln Apt 203, Bradenton, FL 34202-5195 | 2017-04-26 |
| 1609312545 | Pamala Galloway Feehan | Physical Therapist | 7500 Monarch Ln, Fort Myers, FL 33912-2371 | 2017-01-17 |
| 1588106215 | Vincenzo Bombara | Physical Therapist | 6000 Nw 61st St, Parkland, FL 33067-4411 | 2016-11-11 |
| 1437519196 | Daniel Collins | Physical Therapist | 1616 Raincrow Dr, Saint Johns, FL 32259-9080 | 2016-02-24 |
| 1578928420 | Country Club Pt Pa | Physical Therapist | 1331 Whispering Ln, Venice, FL 34285-6449 | 2015-12-19 |
| Find all providers with the same taxonomy | ||||
| City | NORTH MIAMI BEACH |
| Zip Code | 33179 |
Please comment or provide details below to improve the information on MR. KEVIN MICHAEL BLAKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.