Individual
MS. ALEENA VIALVA BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-3131
Mailing address
6505 ECTOR PL, JACKSONVILLE, FL 32211-5403
(904) 329-9785
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F0516152
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003184549A
—
GA
05
—
018284300
—
FL
Enumeration date
05/26/2016
Last updated
04/09/2024
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