| Organization Name: | BLAKE AND FRANKLIN MD PA |
| NPI Number: | 1083936058 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WENDELL O BLAKE (PRESIDENT) |
| Mailing Address: | 505 Martin Luther King Jr Ave Ste 2 Lakeland |
| State: | FL US |
| Postal Code: | 33815 |
| Phone Number: | 8636835567 |
| Fax Number: | 8636865814 |
| NPI Enumeration Date: | 02/18/2010 |
| NPI Last Update Date: | 08/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME 0016779 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |