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General NPI Number Information
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NPI Number | 1730952466
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Entity Type | Individual
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Provider Name | KAI DANARE BLAKE DPT
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Gender | Male
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Dates
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Enumeration Date | 11/03/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 3361 RAYMOND DIEHL BUSINESS LN
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City | TALLAHASSEE
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State | FL
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Zip | 32308-2800
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Country | US
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Telephone | 850-727-5406
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Fax |
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Provider Business Mailing Address
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Address Line | 2319 BRYNMAHR DR # B
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City | TALLAHASSEE
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State | FL
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Zip | 32303-3296
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Country | US
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Telephone | 623-810-7187
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT41029
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License Number State | FL
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