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General NPI Number Information
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NPI Number | 1659501575
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Entity Type | Organization
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Legal Business Name | BLOCK MEDICAL CONSULTING LLC
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 11834 COUNTY ROAD 101
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City | THE VILLAGES
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State | FL
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Zip | 32162-9340
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Country | US
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Telephone | 352-528-2801
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Fax | 352-528-3824
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Provider Business Mailing Address
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Address Line | 3511 WEDGEWOOD LN PO BOX 107
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City | THE VILLAGES
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State | FL
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Zip | 32162-7187
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Country | US
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Telephone | 352-528-2801
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Fax | 352-528-3824
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Authorized Official
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Title or Position | OWNER
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Name | DR. DALE J BLOCK
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Credential | MD
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Telephone | 352-528-2801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME81500
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License Number State | FL
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