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Dr. Perth Agusta Blake, MD
Family Medicine Physician in Tavares, Florida
NPI 1063505105

Perth Agusta Blake is a Family Medicine Physician based in Tavares, FL. Perth Agusta Blake practices in Tavares, FL and has the professional credentials of MD. The NPI Number for Perth Agusta Blake is 1063505105 and holds a License No. ME0069890 (Florida).

The current practice location address for Perth Agusta Blake is 1840 Classique Ln, Tavares, FL and can be reached out via phone at 352-508-5046 and via fax at 352-508-5048.

Location: 1840 Classique Ln, Tavares, FL, 32778-1245
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063505105
Provider Name
Perth Agusta Blake
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1840 Classique Ln, Tavares, FL, 32778-1245
Phone Number
352-508-5046
Fax Number
352-508-5048
Provider Enumeration Date
10/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
31711Y 01 FL MEDICARE ID
255623500 05 FL
institution
Provider Business Practice Location Address Details
Address
1840 Classique Ln
City
Tavares
State
Florida
Zip
32778-5748
Phone Number
352-508-5046
Fax Number
352-508-5048
person
Provider Business Mailing Address Details
Address
1840 Classique Ln
City
Tavares
State
Florida
Zip
32778-5748
Phone Number
352-508-5046
Fax Number
352-508-5048
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
ME0069890 (Florida)
Definition
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.
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