# WAYNE S BLOCKER MD PA

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

## Provider details

- **NPI number:** 1487842506
- **Authorized official:** DR. WAYNE S BLOCKER MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (813) 681-9048

## Contact information

- **Practice address:** 407 N PARSONS AVE, SUITE 101, BRANDON, FL 33510-4537
- **Practice address phone:** (813) 681-9048
- **Practice address fax:** (813) 653-0088
- **Mailing address:** 407 N PARSONS AVE, SUITE 101, BRANDON, FL 33510-4537
- **Mailing address phone:** (813) 681-9048
- **Mailing address fax:** (813) 653-0088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME 26545 | FL | Yes |

## Other

- **Enumeration date:** 10/15/2007
- **Last updated:** 05/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | AI828 | MEDICARE GROUP NUMBER | FL |