BLAKE ERNESTO CARRILLO PA-C
NPI 1588098040
Physician Assistant - Medical in Miami, FL
About Blake Ernesto Carrillo Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLAKE ERNESTO CARRILLO PA-C (NPI 1588098040) is an individual medical provider in Miami, Florida, licensed in Florida (PA9107380) and active in the NPI registry since September 2013. He is enrolled in Medicare PECOS and maintains a secondary practice location in Miami.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blake Ernesto Carrillo Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blake Carrillo's NPI number?
The NPI number for Blake Carrillo is 1588098040. It was assigned to this individual provider in the NPPES registry on September 2, 2013.
Where is Blake Carrillo located?
Blake Carrillo practices at 14150 SW 136th St, Miami, FL 33186. The listed phone number is (786) 204-4600.
What is Blake Carrillo's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Blake Carrillo enrolled in Medicare?
Yes. Blake Carrillo is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Blake Carrillo was last updated on April 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blake Ernesto Carrillo, PA-C · NPI 1588098040
Medical physician in Miami, Florida. Individual provider, active in the CMS NPPES registry since September 2, 2013.
## Identity
- **NPI:** 1588098040 (Entity type: Individual)
- **Enumerated:** September 2, 2013
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA9107380 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 14150 SW 136TH ST, Miami, FL 33186-5506
- **Phone:** (786) 204-4600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** April 28, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1588098040) · Data from the CMS NPPES public registry.