| Wendell O Blake Md Pa | |
|
505 Martin Luther King Jr Avenue Suite 2 Lakeland FL 33815-1527 | |
| (863) 683-5567 | |
| (863) 686-5814 |
| Full Name | Wendell O Blake Md Pa |
|---|---|
| Speciality | General Practice |
| Location | 505 Martin Luther King Jr Avenue, Lakeland, Florida |
| Authorized Official Name and Position | Wendell O Blake (PRESIDENT) |
| Authorized Official Contact | 8636835567 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wendell O Blake Md Pa 505 Martin Luther King Jr Avenue Suite 2 Lakeland FL 33815-1527 Ph: (863) 683-5567 | Wendell O Blake Md Pa 505 Martin Luther King Jr Avenue Suite 2 Lakeland FL 33815-1527 Ph: (863) 683-5567 |
| NPI Number | 1700213972 |
|---|---|
| Provider Enumeration Date | 10/03/2013 |
| Last Update Date | 10/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700213972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME0016779 (Florida) | Primary |
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Premier Walk In Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5676 S Florida Ave, Lakeland, FL 33813 Phone: 863-644-3400 Fax: 863-619-2400 | |
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Bond Clinic Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2039 E Edgewood Dr, Lakeland, FL 33803 Phone: 863-293-1191 | |
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