# BLAKE AND FRANKLIN MD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083936058
- **Authorized official:** MR. WENDELL O BLAKE M.D. (PRESIDENT)
- **Authorized official phone:** (863) 683-5567

## Contact information

- **Practice address:** 505 MARTIN LUTHER KING JR AVE, STE 2, LAKELAND, FL 33815
- **Practice address phone:** (863) 683-5567
- **Practice address fax:** (863) 686-5814
- **Mailing address:** 505 MARTIN LUTHER KING JR AVE, STE 2, LAKELAND, FL 33815
- **Mailing address phone:** (863) 683-5567
- **Mailing address fax:** (863) 686-5814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME 0016779 | FL | — |
| 208D00000X | General Practice Physician | ME0030612 | FL | Yes |

## Other

- **Enumeration date:** 02/18/2010
- **Last updated:** 08/25/2010