Organization
PABLO VALLE BLACIO, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ROOKS (OFFICE MANAGER)
(256) 235-0717
Entity
Organization
Contact information
Practice address
1101 CHRISTINE AVE, ANNISTON, AL 36207-4657
(256) 235-0717
(256) 235-0719
Mailing address
1101 CHRISTINE AVE, ANNISTON, AL 36207-4657
(256) 235-0717
(256) 235-0719
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
20476
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000979
—
AL
01
—
51000979
BLUECROSSBLUESHIELDOFALAB
AL
Enumeration date
05/23/2007
Last updated
12/17/2012
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