Blake, Wayne S

Blake, Wayne S is an individual health care provider with primary practice located at 1700 S Tamiami Trl , Sarasota FL 34239. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Blake, Wayne S can be contacted via phone (941) 917-4896.

Contact Information

Primary practice address
1700 S Tamiami Trl Sarasota FL 34239
Phone: (941) 917-4896
Fax: (941) 917-6884
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X OS 10255 Florida

Profile Details

NPI number 1588661185
LBN Legal business name Blake, Wayne S
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2005
Last updated Aug 23rd, 2018 - 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 1588661185 NPPES
Illinois MEDICAID 036093241
Illinois Other 90278
Illinois MEDICAID 280257100

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