Individual
CLYDE BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
8725 N WICKHAM RD STE 301, MELBOURNE, FL 32940-2240
(321) 434-9200
(321) 434-9202
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-9200
(321) 951-7408
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9210359
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014541700
—
FL
01
—
HX161Y
MEDICARE
FL
01
—
HX161Z
MEDICARE
FL
Enumeration date
07/15/2014
Last updated
04/08/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us