Individual
PATRICIA BLASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10650 WEST STATE ROAD 84 SUIT 206, DAVIE, FL 33324
(954) 634-3636
Mailing address
358 LAKEVIEW DRIVE APT 204, WESTON, FL 33326
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014097600
—
FL
Enumeration date
01/21/2015
Last updated
01/21/2015
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