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General NPI Number Information
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NPI Number | 1922874916
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Entity Type | Organization
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Legal Business Name | BLECKER MD LLC
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 229 SEBASTIAN BLVD
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City | SEBASTIAN
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State | FL
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Zip | 32958-4616
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Country | US
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Telephone | 772-581-0016
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Fax | 772-581-1198
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Provider Business Mailing Address
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Address Line | 14690 SPRING HILL DR STE 101
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City | SPRING HILL
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State | FL
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Zip | 34609-8102
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Country | US
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Telephone | 352-799-0046
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Fax | 352-799-0042
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Authorized Official
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Title or Position | CFO
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Name | KAREN P HAYES
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Credential |
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Telephone | 352-799-0046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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