Individual
HOWARD KIRBY BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3380 66TH ST N, ST PETERSBURG, FL 33710-1539
(855) 834-6911
(813) 354-2714
Mailing address
1009 SHIPWATCH CIRCLE, TAMPA, FL 33602-5736
(855) 834-6911
(813) 354-2714
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
ME12220
FL
2085R0202X
Diagnostic Radiology Physician
ME12220
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME0012220
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0463130000
—
FL
01
—
71373S
ORIGINAL MEDICARE PTAN
FL
01
—
71393
BLUE CROSS
FL
Enumeration date
08/05/2006
Last updated
01/21/2015
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