Individual
JANETTE DE BLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14506 W GRANITE VALLEY DR, SUITE 117, SUN CITY WEST, AZ 85375-6010
(623) 214-1220
(623) 516-9860
Mailing address
14506 W GRANITE VALLEY DR, SUITE 117, SUN CITY WEST, AZ 85375-6010
(623) 214-1220
(623) 516-9860
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16319
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16319
MEDICAL LICENSE-AZ
AZ
Enumeration date
07/09/2006
Last updated
07/09/2007
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