Organization · Type 2 NPI

Wendell O Blake MD PA

General Practice Physician · Lakeland, FL

NPI number 1700213972 Active

Practice location

505 Martin Luther King Jr Avenue, Suite 2
Lakeland, FL 33815-1527

Call (863) 683-5567 Map

Fax (863) 686-5814

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician Primary 208D00000XME0016779 (FL)

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

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About NPI 1700213972

Wendell O Blake MD PA's National Provider Identifier is 1700213972, issued on Oct 3, 2013. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Lakeland, FL. The record was last updated on Oct 3, 2013.