Individual
MRS. BRIDGET BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
9009 CORPORATE LAKE DR, TAMPA, FL 33634-2367
(904) 403-5633
Mailing address
139 E POSITANO AVE, ST AUGUSTINE, FL 32092-4757
(904) 403-5633
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9353436
FL
363LG0600X
Gerontology Nurse Practitioner
ARNP9353436
FL
Other
Enumeration date
06/03/2014
Last updated
01/24/2019
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