MEDICARE: CURTIS MICHAEL BLEAU D.P.M.

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
1	213E00000X	Podiatrist	PO0001753	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480025470	OTHER	FL	RAILROAD
2	CI4974	OTHER	FL	PALMETTO GBA RAILROAD MCARE

General Provider Information

NPI Number	:	1902867120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS MICHAEL BLEAU D.P.M.

Provider Business Mailing Address
First Line	:	3117 SPRING GLEN RD
Second Line	:	STE 402
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5906
Country	:	US
Telephone Number	:	904-224-2001
Fax Number	:	904-224-2002

Provider Business Practice Location Address
First Line	:	1824 BLANDING BLVD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-1904
Country	:	US
Telephone Number	:	904-387-0740
Fax Number	:	904-387-9799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2016

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