PERTH AGUSTA BLAKE

TAVARES, FL
NPI1063505105
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  me0069890)
Enumeration Date2006-10-02
Last Update Date2012-03-16
Business Address
Dr. PERTH AGUSTA BLAKE M.D.
1840 CLASSIQUE LN
TAVARES, FL 32778-5748
Phone number: 352-508-5046
Mailing Address
Dr. PERTH AGUSTA BLAKE M.D.
PO BOX 1245
TAVARES, FL 32778-1245
Phone number: 352-508-5046
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