| Doctor Name: | GREGORY ONEAL BLAND |
| NPI Number: | 1023389160 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 3828 |
| Business Practice Address: | 1012 S 12th St Lantana, FL - 334624432 |
| Business Phone Number: | 8885405553 |
| Business Fax Number: | 5616230126 |
| Mailing Address: | 1012 S 12th St, LANTANA |
| State: | FL |
| Postal Code: | 334624432 |
| Phone Number: | 8885405553 |
| Fax Number: | 5616230126 |
| NPI Enumeration Date: | 01/20/2012 |
| NPI Last Update Date: | 03/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 3828 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |