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Dr. Danice Blaise, MD,MBA
General Practice Physician in Lake Wales, Florida
NPI 1255829966

Danice Blaise is a General Practice Physician based in Orlando, FL. Danice Blaise practices in Lake Wales, FL and has the professional credentials of MD,MBA. The NPI Number for Danice Blaise is 1255829966 and holds a License No. 2019045102 (Florida).

The current practice location address for Danice Blaise is 684 State Road 60 W, Lake Wales, FL and can be reached out via phone at 863-949-4868 and via fax at 863-223-8549.

Location: 684 State Road 60 W, Lake Wales, FL, 32821-6027
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255829966
Provider Name
Danice Blaise
Credential
MD,MBA
Provider Entity Type
Individual
Gender
Male
Address
684 State Road 60 W, Lake Wales, FL, 32821-6027
Phone Number
863-949-4868
Fax Number
863-223-8549
Provider Enumeration Date
04/27/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
115752400 05 FL
institution
Provider Business Practice Location Address Details
Address
684 State Road 60 W
City
Lake Wales
State
Florida
Zip
33853-4419
Phone Number
863-949-4868
Fax Number
863-223-8549
person
Provider Business Mailing Address Details
Address
684 State Road 60 W
City
Lake Wales
State
Florida
Zip
33853-4419
Phone Number
863-949-4868
Fax Number
863-223-8549
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
-
Taxonomy
363A00000X
License No.
CV2000213 (Indiana)
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
2019045102 (Missouri)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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