Individual
TANYA BLAKEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
337 E PALMETTO AVE, LONGWOOD, FL 32750-4277
(321) 614-4217
Mailing address
337 E PALMETTO AVE, LONGWOOD, FL 32750-4277
(321) 614-4217
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Enumeration date
02/03/2015
Last updated
02/04/2015
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