Individual
ALESA MARIE BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13898 NE 38TH AVE, ANTHONY, FL 32617-2301
(352) 598-7099
Mailing address
13898 NE 38TH AVE, ANTHONY, FL 32617-2301
(352) 598-7099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9111748
FL
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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