Individual
MISS DENISE BLACKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
714 E MORGAN ST, BRANDON, FL 33510-4609
(305) 330-0112
Mailing address
714 E MORGAN ST, BRANDON, FL 33510-4609
(305) 330-0112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ARNP11003950
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP11003950
FAMILY NURSE PRACTITIONER
FL
Enumeration date
12/23/2021
Last updated
12/23/2021
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