Blake, Emily A

Blake, Emily A is an individual health care provider with primary practice located at 2627 Riverside Ave Fl 3 , Jacksonville FL 32204-4712. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Blake, Emily A can be contacted via phone (904) 634-0640.

Contact Information

Primary practice address
2627 Riverside Ave Fl 3 Jacksonville FL 32204-4712
Phone: (904) 634-0640
Fax: (904) 634-0203
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X PTA24202 Florida

Profile Details

NPI number 1376903039
LBN Legal business name Blake, Emily A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2016
Last updated Sep 26th, 2018 - about 7 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 1376903039 NPPES
Florida Other PT24202 STATE LICENSE

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