Individual
CIMARON R BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-5422
(352) 273-5927
Mailing address
1309 NORTHGATE CIRCLE, HIXSON, TN 37343
(352) 273-7770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9105054
FL
363AS0400X
Surgical Physician Assistant
PA9105054
FL
Other
Enumeration date
08/11/2009
Last updated
08/30/2021
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