Individual
DR. BLAINE BRADLEY PITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-2245
(321) 843-6624
Mailing address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-2245
(321) 843-6624
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
093600
OH
208000000X
Pediatrics Physician
2005018765
MO
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
ME110544
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003827200
—
FL
01
—
ME110544
MEDICAL LICENSE
FL
Enumeration date
06/11/2007
Last updated
07/01/2019
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