Individual
BLAKE DESENTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
819 PARK TRAIL DRIVE, MINNEOLA, FL 34715
(352) 459-1787
Mailing address
819 PARK TRAIL DR, MINNEOLA, FL 34715-7742
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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