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General NPI Number Information
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NPI Number | 1942823711
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL PA
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Dates
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Enumeration Date | 05/27/2020
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Last Update Date | 05/27/2020
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Provider Practice Location Address
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Address Line | 11419 W PALMETTO PARK RD UNIT 97081
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City | BOCA RATON
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State | FL
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Zip | 33497-2501
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Country | US
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Telephone | 561-843-8460
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Fax | 561-922-3211
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Provider Business Mailing Address
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Address Line | 11419 W PALMETTO PARK RD UNIT 97081
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City | BOCA RATON
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State | FL
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Zip | 33497-2501
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Country | US
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Telephone | 561-843-8460
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Fax | 561-922-3211
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Authorized Official
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Title or Position | DO/OWNER
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Name | WAYNE S BLAKE
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Credential | DO
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Telephone | 561-843-8460
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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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