JEFFREY W BLAKE MD NPI 1164431185

NPI Information

NPI: 1164431185
Provider Name: JEFFREY W BLAKE, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Address:
1620 NECTARINE ST
FERNANDINA BEACH, FL
ZIP 32034
Phone: (904) 548-1860
Get Directions

Jeffrey W Blake, MD is a cardiovascular disease internal medicine in Fernandina Beach, FL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Jeffrey W Blake, MD NPI is 1164431185. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1620 NECTARINE ST
FERNANDINA BEACH, FL
ZIP 32034-724
Phone: (904) 548-1860
Fax: (904) 277-7283

The enumeration date for this NPI number is 8/7/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	LL478	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C07193	MEDICARE UPIN	FLORIDA
2	E1353Z	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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