Individual provider · Type 1 NPI

Blake Ernesto Carrillo, PA-C

Medical Physician Assistant · Miami, FL

NPI number 1588098040 Active

Practice location

14150 SW 136th St
Miami, FL 33186-5506

Mailing address

173 Kings Way
Royal Palm Beach, FL 33411-1568

Other practice locations

  • 14100 SW 136th St, Miami, FL 33186-5506 · (786) 204-4600

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9107380 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1588098040

Blake Ernesto Carrillo, PA-C's National Provider Identifier is 1588098040, issued on Sep 2, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Miami, FL. The record was last updated on Apr 28, 2020.