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NPI Code Detail

MEDICARE: ZAQUEZ BLANKUMSEE

MEDICARE: ZAQUEZ BLANKUMSEE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1346039930
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZAQUEZ BLANKUMSEE
Provider Business Mailing Address
First Line : 4988 ADEL HWY
Second Line :
City : QUITMAN
State : GA
Zip : 31643-8527
Country : US
Telephone Number : 229-460-9965
Fax Number :
Provider Business Practice Location Address
First Line : 1983 MAHAN DR STE C
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-6121
Country : US
Telephone Number : 850-772-0855
Fax Number : 448-200-1999
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2025
Last Update Date : 05/01/2025

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Directions to “ ZAQUEZ BLANKUMSEE ” Practice Location

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