Individual
DR. BLAINE RICHARD HERIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
455 PINELLAS ST, SUITE 320, CLEARWATER, FL 33756-3369
(727) 446-2273
(727) 441-4966
Mailing address
PO BOX 10744, CLEARWATER, FL 33757-8744
(727) 532-0002
(727) 266-4943
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME73348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252274880
—
FL
01
—
P01735276
RAILROAD MEDICARE PROVIDER NUMBER
FL
Enumeration date
02/15/2006
Last updated
12/05/2016
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