Individual
BLAKE L KENDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10101 W FOREST HILL BLVD, WELLINGTON, FL 33414-6103
(561) 798-8535
Mailing address
PO BOX 24085, FORT WORTH, TX 76124-1085
(817) 451-4208
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS9665
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56476
BCBS OF FLORIDA
FL
Enumeration date
07/07/2006
Last updated
10/17/2007
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