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NPI Code Detail

MEDICARE: BLAKE EDWARD DOBBELMANN

MEDICARE: BLAKE EDWARD DOBBELMANN
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 TechnicianRBT-22-210733

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730786716
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLAKE EDWARD DOBBELMANN
Provider Business Mailing Address
First Line : PO BOX 259
Second Line :
City : SHALIMAR
State : FL
Zip : 32579-0259
Country : US
Telephone Number : 850-362-6824
Fax Number :
Provider Business Practice Location Address
First Line : 3355 ADDISON DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-7065
Country : US
Telephone Number : 850-362-6824
Fax Number : 850-626-6132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2020
Last Update Date : 05/27/2025

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Directions to “ BLAKE EDWARD DOBBELMANN ” Practice Location

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