BLAKE ERNESTO CARRILLO PA-C NPI 1588098040

NPI Information

NPI: 1588098040
Provider Name: BLAKE ERNESTO CARRILLO, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
14150 SW 136TH ST
MIAMI, FL
ZIP 33186
Phone: (786) 204-4600
Get Directions

Blake Ernesto Carrillo, PA-C is a medical physician assistant in Miami, FL. Blake Ernesto Carrillo, PA-C NPI is 1588098040. 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:

14150 SW 136TH ST
MIAMI, FL
ZIP 33186-506
Phone: (786) 204-4600

The NPI 1588098040 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/2/2013 and was last updated on 4/28/2020.

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	363AM0700X	Physician Assistant	Medical	PA9107380	FLORIDA	Yes

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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