Individual provider · Type 1 NPI

Thomas B. Blake Iii, MD

Specialist · Maitland, FL

NPI number 1508873787 Active

Practice location

331 N Maitland Ave, Suite A-2
Maitland, FL 32751-4762

Call (407) 629-5141 Map

Fax (407) 629-5858

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XME65263 (FL)
Specialist 174400000X033032 (GA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1508873787

Thomas B. Blake Iii, MD's National Provider Identifier is 1508873787, issued on Aug 1, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Maitland, FL. The record was last updated on Jan 3, 2011.