JEFFREY W BLAKE (NPI# 1164431185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164431185 |
Entity Type | Individual |
Full Name | JEFFREY W BLAKE |
Credential | MD |
Practice Address |
1620 Nectarine St Fernandina Beach FL 32034-4724 |
Mailing Address |
Po Box 517 Fernandina Beach FL 32035-0517 |
Practice Telephone | 9045481860 |
Practice Fax Number | 9042777283 |
Mailing Telephone | 9045481800 |
Mailing Fax Number | 9042777286 |
Enumeration Date | 2006-08-07 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
LL478 | FL | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003827239 | Jeffrey Blake | Social Worker | 22 Monument Square, #403, Portland, ME 04101-3914 | 2006-08-11 |
1407834781 | Jeffrey Lee Blake | Physical Therapist | 1714 17th St, Santa Monica, CA 90404-4410 | 2006-01-06 |
1477545127 | Jeffrey M Blake | Obstetrics & Gynecology | 141 W 22nd St Ste 309, Anderson, IN 46016-4389 | 2005-08-18 |
1639616295 | Jeffrey Blake | Behavior Technician | 474 W 200 N, St George, UT 84770-4505 | 2017-01-20 |
1093734451 | Jeffrey Blake | Pediatrics | 317 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2006-07-18 |
1992792980 | Jeffrey D. Blake | Obstetrics & Gynecology | 250 Green St, Gardner, MA 01440-1396 | 2005-10-04 |
Street Address |
1620 NECTARINE ST |
City | FERNANDINA BEACH |
State | FL |
Zip Code | 32034-4724 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316956394 | Sherry Sue Linback | Nurse Practitioner | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2006-08-07 |
1841435625 | Charles Leigh Christian | Internal Medicine | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2008-12-09 |
1780875948 | Karelyn E Lotz | Contractor | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2007-08-05 |
1114142635 | James R Gildenston | Podiatrist | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2007-04-17 |
1801934203 | William Edward Hansberry | Pediatrics | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2007-02-01 |
1063421063 | Kimberly Gayle Geib | Nurse Practitioner | 1620 Nectarine St, Fernandina Beach, FL 32034-4724 | 2006-08-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871059899 | Anna Fn Chu | Dietitian, Registered | Baptist Medical Center Nassau, 1250 South 18th Street, Fernandina Beach, FL 32034 | 2019-02-14 |
1841784550 | Kelly Ann Sayers | Social Worker | 1890 S 14th St Ste 110, Fernandina Beach, FL 32034 | 2018-06-15 |
1609302611 | Christian Giovanniello | Behavior Technician | 1743 Azalea Street, Fernandina Beach, FL 32034 | 2017-05-11 |
1770018467 | Beckerton Chiropractic Pllc | Chiropractor | 464073 East State Road 200, Yulee, FL 32034 | 2017-05-01 |
1114392438 | Jayde Marie Gray | Chiropractor | 5211 South Fletcher Ave., Suite 250, Amelia Island, FL 32034 | 2015-12-11 |
1760858369 | Sun Gallery Inc. | Eyewear Supplier (Equipment, not the service) | 1523 Sadler Road, Fernandina Beach, FL 32034 | 2015-08-18 |
1124419718 | Angela L Michels | Counselor | 1890 S. 14th St., #302, Fernandina Beach, FL 32034 | 2015-02-18 |
1336542075 | Sara Veronica Herreros | Physician Assistant | 1865 Lime Street, Suite 100, Fernandina Beach, FL 32034 | 2014-10-08 |
1366789471 | Elizabeth Ann Moore | Nurse Practitioner | 1348 S 18th St Ste 340, Fernandina Beach, FL 32034 | 2013-01-09 |
1043564289 | Summer Suzanne Delille | Dental Hygienist | 95054 Oriole St., Fernandina Beach, FL 32034 | 2012-11-08 |
Find all providers in zip 32034 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033318928 | George Glenn Le-bert | Internal Medicine | 1340 S 18th St Ste 202, Credentialing Department, Fernandina Beach, FL 32034-4733 | 2007-07-12 |
1013274158 | John Hartwell Houston Mooney | Internal Medicine | 1348 S 18th St Ste 200, Fernandina Beach, FL 32034 | 2012-04-13 |
1073886065 | Baptist Cardiology, Inc. | Internal Medicine | 1340 S 18th St, Building A, Suite 202, Fernandina Beach, FL 32034-4799 | 2012-02-22 |
1396013702 | Physicians Group Services | Internal Medicine | 2334 S 8th St, Fernandina Beach, FL 32034-1979 | 2011-12-13 |
1629263496 | Amelia Institute of Cardiology and Medicine | Internal Medicine | 2334 S 8th St, Fernandina Beach, FL 32034-1979 | 2007-09-13 |
1275636805 | Farid Ullah | Internal Medicine | 1348 S 18th St, Bldg B, Suite 200, Fernandina Beach, FL 32034-4785 | 2006-09-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437765443 | Premier Cardiovascular Center, LLC | Internal Medicine | 450 W State Road 434 Ste 2010, Longwood, FL 32750-5187 | 2020-09-16 |
1679199236 | Tallahassee Memorial Healthcare Inc | Internal Medicine | 877 3rd St Ste 3, Chipley, FL 32428-1855 | 2020-06-19 |
1972123701 | Heart Clinic of Central Florida LLC | Internal Medicine | 52 Riley Rd # 429, Celebration, FL 34747-5420 | 2020-04-22 |
1205465440 | Cardiology Group Panel LLC | Internal Medicine | 201 Nw 82nd Ave Ste 405, Plantation, FL 33324-1883 | 2020-04-08 |
1346876745 | H & D Cardiology, Pa | Internal Medicine | 1879 Nightingale Ln Ste B2, Tavares, FL 32778-4363 | 2020-03-17 |
1427690775 | The Cardiac and Vascular Institute Ambulatory Surgery Center | Internal Medicine | 4645 Nw 8th Ave Ste 10, Gainesville, FL 32605-4688 | 2019-10-08 |
1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
1023660255 | Florida Medical Specialists LLC | Internal Medicine | 1250 S Tamiami Trl Ste 300, Sarasota, FL 34239-2221 | 2019-07-09 |
1962064493 | Ckk Medical LLC | Internal Medicine | 6600 Sw State Road 200 # 200, Ocala, FL 34476-5554 | 2019-07-04 |
1952968026 | Jose Miguel Simo | Internal Medicine | 3347 S State Road 7 Ste 205, Wellington, FL 33449-8148 | 2019-05-23 |
Find all providers with the same taxonomy |
City | FERNANDINA BEACH |
Zip Code | 32034 |
Please comment or provide details below to improve the information on JEFFREY W 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.