Individual
BLAKE WHITMARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(386) 624-1913
Mailing address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(386) 624-1913
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
025073
NY
363A00000X
Physician Assistant
25073
NY
363A00000X
Physician Assistant
Primary
PA9115808
FL
Other
Enumeration date
06/19/2020
Last updated
07/03/2023
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