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Individual

DR. BLAKE JOSEPH EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1725 N UNIVERSITY DR STE 400, CORAL SPRINGS, FL 33071-6053
(954) 752-3166
(954) 753-5628
Mailing address
1725 N UNIVERSITY DR STE 400, CORAL SPRINGS, FL 33071-6053
(954) 752-3166
(954) 753-5628

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME117404
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009591500
FL
01
1193019
WELLCARE
FL
01
14RS8
BCBS OF FL
FL
01
368241
AVMED
FL
01
4955788
AETNA
FL
01
7735843
CIGNA
FL
01
P01230859
RAILROAD MCR
FL
01
P1011066
FREEDOM HEALTH
FL
Enumeration date
08/05/2008
Last updated
09/16/2022
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