Individual
FITZ BLAKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 MICCOSUKEE ROAD, BIXLER EMERGENCY CENTER, TALLAHASSEE, FL 32308
(850) 431-0911
(850) 431-0779
Mailing address
1300 MICCOSUKEE ROAD, BIXLER EMERGENCY CENTER, TALLAHASSEE, FL 32308
(850) 431-0911
(850) 431-0779
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301094830
MI
207P00000X
Emergency Medicine Physician
Primary
ME115973
FL
Other
Enumeration date
07/16/2009
Last updated
05/24/2013
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