Organization
WAYNE S BLOCKER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WAYNE S BLOCKER MD (PHYSICIAN/OWNER)
(813) 681-9048
Entity
Organization
Contact information
Practice address
407 N PARSONS AVE, SUITE 101, BRANDON, FL 33510-4537
(813) 681-9048
(813) 653-0088
Mailing address
407 N PARSONS AVE, SUITE 101, BRANDON, FL 33510-4537
(813) 681-9048
(813) 653-0088
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 26545
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AI828
MEDICARE GROUP NUMBER
FL
Enumeration date
10/15/2007
Last updated
05/14/2008
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