Individual
MRS. ALICE M PAYNE-BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
540 NE 179TH DR, MIAMI, NORTH MIAMI BEACH, FL 33162-1922
(305) 650-9024
Mailing address
540 NE 179TH DR, NORTH MIAMI BEACH, FL 33162-1922
(305) 650-9024
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
718051
FL
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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