Individual
ROBERT F BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MMS, PA-C
Contact information
Practice address
1447 MEDICAL PARK BLVD, SUITE #101, WELLINGTON, FL 33414-3164
(561) 844-0120
(561) 800-1074
Mailing address
1447 MEDICAL PARK BLVD, SUITE #101, WELLINGTON, FL 33414-3164
(561) 844-0120
(561) 800-1074
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9103551
FL
Other
Enumeration date
10/11/2006
Last updated
02/22/2012
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