Organization
STEVE BLICBLUM M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ILLENE BLICBLUM (GROUP ADMINISTRATOR)
(813) 685-5459
Entity
Organization
Contact information
Practice address
900 GRIFFIN RD, LAKELAND, FL 33805-2442
(863) 686-1711
(813) 681-5403
Mailing address
PO BOX 852, BRANDON, FL 33509-0852
(813) 685-5459
(813) 681-5403
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
11/16/2006
Last updated
08/22/2020
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