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General NPI Number Information
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NPI Number | 1699128454
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Entity Type | Individual
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Provider Name | JOSEPH BLAISE
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Gender | Male
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 1298 NW 79TH ST APT 108
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City | MIAMI
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State | FL
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Zip | 33147-8252
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Country | US
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Telephone | 305-807-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 1298 NW 79TH ST APT 108
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City | MIAMI
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State | FL
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Zip | 33147-8252
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Country | US
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Telephone | 305-807-0040
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Fax |
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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 | 2279H0200X
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Taxonomy Name | Home Health Registered Respiratory Therapist
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License Number | RT8237
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License Number State | FL
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