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Wendell O Blake Md Pa
General Practice Physician in Lakeland, Florida
NPI 1700213972

Wendell O Blake Md Pa is a General Practice Physician based in Lakeland, FL. Wendell O Blake Md Pa practices in Lakeland, FL. The NPI Number for Wendell O Blake Md Pa is 1700213972 and holds a License No. ME0016779 (Florida).

The current practice location address for Wendell O Blake Md Pa is 505 Martin Luther King Jr Avenue, Lakeland, FL and can be reached out via phone at 863-683-5567 and via fax at 863-686-5814.

Location: 505 Martin Luther King Jr Avenue, Lakeland, FL, 33815-1527
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1700213972
Provider Name
Wendell O Blake Md Pa
Credential
Provider Entity Type
Organization
Address
505 Martin Luther King Jr Avenue, Lakeland, FL, 33815-1527
Phone Number
863-683-5567
Fax Number
863-686-5814
Provider Enumeration Date
10/03/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
505 Martin Luther King Jr Avenue
City
Lakeland
State
Florida
Zip
33815-1527
Phone Number
863-683-5567
Fax Number
863-686-5814
person
Provider Business Mailing Address Details
Address
505 Martin Luther King Jr Avenue
City
Lakeland
State
Florida
Zip
33815-1527
Phone Number
863-683-5567
Fax Number
863-686-5814
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
ME0016779 (Florida)
Definition
Definition to come...
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