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1588098040
BLAKE ERNESTO CARRILLO
MIAMI, FL
NPI
1588098040
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: FL PA9107380)
Enumeration Date
2013-09-02
Last Update Date
2020-04-28
Business Address
BLAKE ERNESTO CARRILLO PA-C
14150 SW 136TH ST
MIAMI, FL 33186-5506
Phone number: 786-204-4600
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Mailing Address
BLAKE ERNESTO CARRILLO PA-C
173 KINGS WAY
ROYAL PALM BEACH, FL 33411-1568
Phone number: 786-316-5665
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