Individual provider · Type 1 NPI

Danice Blaise, MD, MBA

General Practice Physician · Lake Wales, FL

NPI number 1255829966 Active

Practice location

684 State Road 60 W
Lake Wales, FL 33853-4419

Call (863) 949-4868 Map

Fax (863) 223-8549

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027

Other practice locations

  • 571 Avenue K SE, Winter Haven, FL 33880-4215 · (407) 440-0708

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician Primary 208D00000XACN1418 (FL)
Internal Medicine Physician 207R00000X25173 (NH)
Physician Assistant 363A00000X2019045102 (MO)
Physician Assistant 363A00000XCV2000213 (IN)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

4 other providers at this address

Other general practice physician providers in Lake Wales

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About NPI 1255829966

Danice Blaise, MD, MBA's National Provider Identifier is 1255829966, issued on Apr 27, 2018. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Lake Wales, FL. The record was last updated on Dec 7, 2024.