Individual
DR. GERMAINE M BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1130 HICKORY ST STE B, MELBOURNE, FL 32901
(321) 361-5602
(321) 952-6179
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5600
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME78051
FL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
ME78051
FL
207RX0202X
Medical Oncology Physician
Primary
ME78051
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261306900
—
FL
01
—
58954Q
MEDICARE
FL
Enumeration date
04/05/2006
Last updated
12/05/2024
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