Individual
BLESSY MATHEW JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
714 DOCTORS DR, ENGLEWOOD, FL 34223
(941) 460-1300
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 432-8500
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME113758
FL
207RX0202X
Medical Oncology Physician
Primary
ME113758
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014759800
—
FL
Enumeration date
05/12/2009
Last updated
08/08/2022
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