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1700213972
WENDELL O BLAKE MD PA
LAKELAND, FL
NPI
1700213972
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Entity Type
Organization
Authorized Contact
WENDELL O BLAKE
President
863-683-5567
Organization Subpart ?
No
Primary Taxonomy
208D00000X General Practice
(Licence: FL ME0016779)
Enumeration Date
2013-10-03
Last Update Date
2013-10-03
Business Address
WENDELL O BLAKE MD PA
505 MARTIN LUTHER KING JR AVENUE SUITE 2
LAKELAND, FL 33815-1527
Phone number: 863-683-5567
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Mailing Address
WENDELL O BLAKE MD PA
505 MARTIN LUTHER KING JR AVENUE SUITE 2
LAKELAND, FL 33815-1527
Phone number: 863-683-5567
Copy
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