Individual
SHAMEKA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43 DELORIS MADISON DR, MIDWAY, FL 32343-2250
(850) 694-5585
Mailing address
43 DELORIS MADISON DR, MIDWAY, FL 32343-2250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9542974
FL
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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