Individual
BLAKE MAROTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1658 NE MIAMI GARDENS DR, MIAMI, FL 33179-4900
(305) 949-4221
Mailing address
673 NE 3RD AVE APT 345, FORT LAUDERDALE, FL 33304-2742
(754) 317-1129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5940
FL
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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