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General NPI Number Information
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NPI Number | 1184698664
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Entity Type | Individual
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Provider Name | LAURIE E BLACH MD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 6129 SW 70TH ST
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-3451
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Country | US
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Telephone | 786-871-6800
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Fax | 786-871-6801
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Provider Business Mailing Address
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Address Line | PO BOX 565338
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City | MIAMI
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State | FL
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Zip | 33256-5338
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Country | US
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Telephone | 786-202-3051
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Fax | 305-861-2349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME68778
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License Number State | FL
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