Organization
DR KENNETH BLAZE PA AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL D GONZALEZ MD (MD)
(954) 433-4200
Entity
Organization
Contact information
Practice address
1 SW 129TH AVE, SUITE 109, PEMBROKE PINES, FL 33027-1761
(954) 433-4200
(954) 433-7710
Mailing address
1 SW 129TH AVE, SUITE 109, PEMBROKE PINES, FL 33027-1761
(954) 433-4200
(954) 433-7710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/15/2007
Last updated
12/09/2009
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