# BLAISE PODIATRY

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

## Provider details

- **NPI number:** 1104267673
- **Authorized official:** DR. ALEXANDER BLAISE DPM (OWNER)
- **Authorized official phone:** (305) 761-1262

## Contact information

- **Practice address:** 3500 NW 17TH AVE, MIAMI, FL 33142-5540
- **Practice address phone:** (305) 761-1262
- **Practice address fax:** (305) 675-8164
- **Mailing address:** 9640 NW 10TH CT, PLANTATION, FL 33322-4851
- **Mailing address phone:** (305) 424-9301
- **Mailing address fax:** (305) 424-9301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | PO3526 | FL | Yes |

## Other

- **Enumeration date:** 07/12/2013
- **Last updated:** 01/22/2019