Blake, Charles Richard

Blake, Charles Richard is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-0371. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Blake, Charles Richard can be contacted via phone (352) 392-3451.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-0371
Phone: (352) 392-3451
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 29828 South Carolina
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME90057 Florida

Profile Details

NPI number 1386645224
LBN Legal business name Blake, Charles Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Jun 1st, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386645224 NPPES
North Carolina Other 32840 OPTICARE
North Carolina Other 0800815 OPTICARE
North Carolina Other 0800815 OPTICARE
North Carolina Other 806940 OPTICARE
North Carolina MEDICAID GP4696 OPTICARE
North Carolina MEDICAID 010129300 OPTICARE
North Carolina MEDICAID 5902230 OPTICARE
North Carolina Other 806940 OPTICARE
North Carolina Other 183075 OPTICARE
North Carolina Other 141A6 OPTICARE
North Carolina Other OPH174 OPTICARE
North Carolina Other 7273542 OPTICARE

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