Perth Agusta Blake M.D.

NPI 1063505105 - Family Medicine - 207Q00000X

NPI Details
NPI 1063505105
Gender Male
Enumeration Date 10/02/2006
Last Updated 03/16/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
TAVARES FL, 32778-5748, US
Phone (352) 508-5046
Fax (352) 508-5048
Business Location
PO BOX 1245
TAVARES FL, 32778-1245, US
Phone (352) 508-5046
Taxonomy Code 207Q00000X
License State Florida
License Number ME0069890
Remove 1063505105 NPI Number

According to our database, Dr. Perth Agusta Blake M.D. NPI is 1063505105, taxonomy code is 207Q00000X and license number is ME0069890, license state is located at Florida. Perth Agusta Blake M.D. physically located at 1840 Classique Ln, Tavares FL, 32778-5748. NPI Number Perth Agusta Blake M.D. has the Individual type.

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1063505105 NPI number is provided on an as is basis without warranty of any kind. 1063505105 is maintained by the National Plan & Provider Enumeration System. The contents of Perth Agusta Blake M.D. are for informational purposes only.