Organization
JACKY BLANK MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACKY BRUCE BLANK MD (DIRECTOR)
(305) 933-8433
Entity
Organization
Contact information
Practice address
20814 W DIXIE HWY, AVENTURA, FL 33180-1147
(305) 933-8433
Mailing address
20814 W DIXIE HWY, AVENTURA, FL 33180-1147
(305) 933-8433
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME 101336
FL
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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