DR. WENDELL OWEN BLAKE (NPI# 1235287095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1235287095 |
Entity Type | Individual |
Full Name | DR. WENDELL OWEN BLAKE |
Practice Address |
505 Martin Luther King Ave Suite 2 Lakeland FL 33815 |
Practice Telephone | 8636835567 |
Mailing Telephone | 8636835567 |
Enumeration Date | 2007-01-08 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | ME0016779 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 055666100 | 05 |
Street Address |
505 MARTIN LUTHER KING AVE SUITE 2 |
City | LAKELAND |
State | FL |
Zip Code | 33815 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174162093 | Deborah Beall Boynton | Counselor | 219 Hillcrest St, Lakeland, FL 33815 | 2019-12-23 |
1992247373 | Lizvel Rosario | Counselor | 220 Lake Wire Dr., Lakeland, FL 33815 | 2016-11-16 |
1235554783 | Florida Baptist Children's Homes | Community Based Residential Treatment Facility, Mental Illness | 1015 Sikes Blvd., Lakeland, FL 33815 | 2014-02-20 |
1902229255 | Christina Miller | Nurse Practitioner | 6850 New Tampa Hwy Ste 600, Lakeland, FL 33815 | 2014-01-22 |
1902111099 | Jeanene Nicole Robinson-kyles | Psychologist | 505 Martin L. King Jr. Ave, Suite 1, Lakeland, FL 33815 | 2010-08-12 |
1104983899 | Lake Wire Pharmacy Inc | Pharmacist | 505 Martin Luther King Jr Ave, Suite 3, Lakeland, FL 33815 | 2007-01-02 |
1427038637 | Rotech Oxygen and Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 5315 Great Oak Drive, Lakeland, FL 33815 | 2006-01-23 |
1598205841 | Daphne Toussaint | Dentist | 607 S Missouri Ave, Lakeland, FL 33815 | 2017-03-06 |
1083936058 | Blake and Franklin Md Pa | General Practice | 505 Martin Luther King Jr Ave, Ste 2, Lakeland, FL 33815 | 2010-02-18 |
1851398705 | Richard W Merritt Dc Pa | Chiropractor | 1253 W Memorial Blvd, Lakeland, FL 33815-0602 | 2005-07-07 |
Find all providers in zip 33815 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174121909 | Amanda Millican | Family Medicine | 605 Laura Rd, Lakeland, FL 33815-3220 | 2020-10-14 |
1093320848 | Katrena Borders Flowers | Family Medicine | 2629 Highlands Creek Way, Lakeland, FL 33813-6301 | 2020-09-09 |
1578177523 | Robinson Family Clinic Inc | Family Medicine | 4406 S Florida Ave Ste 30, Lakeland, FL 33813-2176 | 2020-09-06 |
1306467311 | Christopher James Miller | Family Medicine | 215 S Elm Rd, Lakeland, FL 33801-2310 | 2020-04-30 |
1811480387 | Victoria Anne Morin | Family Medicine | 1463 Town Center Dr, Lakeland, FL 33803-7966 | 2018-06-10 |
1467890665 | Rachael Veronique Ollivierre-agard | Family Medicine | 170 Fitzgerald Rd Ste 1, Lakeland, FL 33813-2633 | 2013-06-10 |
1740587211 | Javier Andres Diago Benjumea | Family Medicine | 3015 Lakeland Highlands Rd, Lakeland, FL 33803-4339 | 2011-02-18 |
1891099792 | Sergio B Seoane Md Pa | Family Medicine | 118 Allamanda Sr, Lakeland, FL 33803 | 2011-01-06 |
1063673812 | Avantica Gondi | Family Medicine | 1818 Harden Blvd Ste 120, Lakeland, FL 33803-1813 | 2008-06-24 |
1942460902 | Michael Curtiss | Family Medicine | 2039 E Edgewood Dr, Suite B, Lakeland, FL 33803-3601 | 2008-06-12 |
Find all providers in LAKELAND |
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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.