MEDICARE: KENYA ALICIA BLAKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	11044595	FL

General Provider Information

NPI Number	:	1144187030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENYA ALICIA BLAKE

Provider Business Mailing Address
First Line	:	388 NW 89TH LN
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-7449
Country	:	US
Telephone Number	:	786-781-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	388 NW 89TH LN
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33071-7449
Country	:	US
Telephone Number	:	786-781-1188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

Similar Medicare Providers

1982933487 — ATLAS HEALTHCARE AND REHAB HOLLY SPRINGS
Practice Location Address:

2945 HOLLY SPRINGS PKWY
CANTON, GA
30115-7449

Practice Phone: 678-214-0100
Practice Fax:

1629783527 — IDELET GUTIERREZ GOMEZ
Practice Location Address:

1263 NW 87TH AVE
CORAL SPRINGS, FL
33071-7176

Practice Phone: 786-578-4183
Practice Fax:

1396301743 — BRAIN GAINS THERAPY SOLUTIONS, LLC
Practice Location Address:

11120 NW 10TH PL
CORAL SPRINGS, FL
33071-6302

Practice Phone: 754-216-8839
Practice Fax:

1922965102 — FANEEZA RUSTAM
Practice Location Address:

1515 N UNIVERSITY DR STE 221
CORAL SPRINGS, FL
33071-6032

Practice Phone: 561-778-2640
Practice Fax:

1508724501 — TAYLER SHEA O'HALLORAN
Practice Location Address:

11658 NW 19TH DR
CORAL SPRINGS, FL
33071-5742

Practice Phone: 954-551-4883
Practice Fax:

1245235688 — CHRISTOPHER T. CHEN MD
Practice Location Address:

2101 RIVERSIDE DR , SUITE 101
CORAL SPRINGS, FL
33071-6260

Practice Phone: 954-341-6200
Practice Fax: 239-341-6204

Directions to “ KENYA ALICIA BLAKE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.