Individual
MR. MOSI BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L/ATC
Contact information
Practice address
305 E BRANDON BLVD, BRANDON, FL 33511-5222
(813) 978-9700
(813) 558-6187
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
(813) 558-6187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2928
FL
Other
Enumeration date
12/31/2017
Last updated
04/22/2021
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