Individual
ALICE BLAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5955 PONCE DE LEON BLVD, CORAL GABLES, FL 33146-2423
(305) 662-8668
(305) 662-3723
Mailing address
5955 PONCE DE LEON BLVD, CORAL GABLES, FL 33146-2423
(305) 662-8668
(305) 662-3723
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
OS7055
FL
2080P0202X
Pediatric Cardiology Physician
Primary
OS7055
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263661700
—
FL
Enumeration date
10/07/2005
Last updated
03/25/2014
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