WENDELL O BLAKE MD PA (NPI# 1700213972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700213972 |
Entity Type | Organization |
Organization Name | WENDELL O BLAKE MD PA |
Practice Address |
505 Martin Luther King Jr Avenue Suite 2 Lakeland FL 33815-1527 |
Practice Telephone | 8636835567 |
Practice Fax Number | 8636865814 |
Mailing Telephone | 8636835567 |
Mailing Fax Number | 8636865814 |
Enumeration Date | 2013-10-03 |
Last Update Date | 2013-10-03 |
Authorized Official Name | WENDELL O BLAKE (PRESIDENT) |
Authorized Official Telephone | 8636835567 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | ME0016779 | FL | Allopathic & Osteopathic Physicians |
Street Address |
505 MARTIN LUTHER KING JR AVENUE SUITE 2 |
City | LAKELAND |
State | FL |
Zip Code | 33815-1527 |
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 |
1235287095 | Wendell Owen Blake | Family Medicine | 505 Martin Luther King Ave, Suite 2, Lakeland, FL 33815 | 2007-01-08 |
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 |
Find all providers in zip 33815 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811517840 | Kecia Howell | General Practice | 7433 Us Highway 98 N, Lakeland, FL 33809-2140 | 2020-04-20 |
1114393469 | Lakeland Regional Health Systems, Inc. | General Practice | 811 S Lakeside Ave, Lakeland, FL 33815-4771 | 2015-08-20 |
1649572249 | Lysmar Carrion Dinguis | General Practice | 4725 Us Highway 98 S Ste 101, Lakeland, FL 33812-4334 | 2010-12-02 |
1891945580 | Luis J. Velazquez Vicente | General Practice | 4120 Us Highway 98 N, Suite 200, Lakeland, FL 33809-3854 | 2008-09-30 |
1225227051 | Lenny Tua Mendez | General Practice | 4725 Us Highway 98 S Ste 102, Lakeland, FL 33812-4334 | 2007-10-17 |
1841344454 | Evans Salomon Mercier | General Practice | 5020 Williamstown Blvd, Lakeland, FL 33810-3707 | 2007-01-22 |
1174690358 | Prudencio P Aqui | General Practice | 2133 S Combee Rd, Sterling Square, Lakeland, FL 33801 | 2006-11-30 |
1225134745 | Esther Echevarria | General Practice | 3810 S Florida Ave, Lakeland, FL 33813-1105 | 2006-09-15 |
1164539870 | Luis Garcia Rivera | General Practice | 5425 S Florida Ave, Lakeland, FL 33813 | 2006-08-25 |
1851309298 | Mari C Fielding Md Pa | General Practice | 2720 Nevada Rd, Lakeland, FL 33803 | 2006-08-03 |
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.