Kimberly T. Blake PA
Physician Assistant in Sanford, FL(View on Map)
Full Name
Kimberly Thornton Blake PA
NPI Number
1295030195
NPI Type
Individual Provider
Gender
Female
Enumeration Date
01/24/2011
Specialties
(Taxonomies)Licenses
State
Florida
License Number
PA9105774
Contact
Information
Purpose
Mailing
Location
Address
200 CORPORATE BLVD
1401 W SEMINOLE BLVD
City
Lafayette
Sanford
State
LA
FL
Postal Code
70508-3870
32771-6743
Country
US
US
Telephone Number
(800) 893-9698
(800) 893-9698
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 01/24/2011
Provider Address
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