Individual
BLAKELE BAKKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7720 US HIGHWAY 98 W STE 310, MIRAMAR BEACH, FL 32550
(850) 267-2961
Mailing address
135 COUNTRY CLUB DR W, DESTIN, FL 32541-4400
(850) 585-9461
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME139711
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME139711
FLORIDA MEDICAL LICENSE
FL
Enumeration date
04/09/2015
Last updated
03/07/2023
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