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WENDELL O BLAKE MD PA
NPI 1700213972
General Practice in Lakeland, FL

Active since October 03, 2013
505 MARTIN LUTHER KING JR AVENUE, SUITE 2, LAKELAND, FL 33815(863) 683-5567(863) 686-5814 Get Directions Write a Review

NPPES record last updated: October 3, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wendell O Blake Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WENDELL O BLAKE MD PA (NPI 1700213972) is a healthcare organization registered as a general practice in Lakeland, Florida and active in the NPI registry since October 2013. The organization lists Wendell O Blake, President, as its authorized official.

NPPES Registry Identity

NPI1700213972
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameWENDELL O BLAKE MD PA
Location Address505 MARTIN LUTHER KING JR AVENUE, SUITE 2Lakeland, FL 33815-1527
Mailing Address505 Martin Luther King Jr Avenue, Suite 2Lakeland, FL 33815-1527 · (863) 683-5567 · Fax (863) 686-5814
Phone(863) 683-5567
Fax(863) 686-5814
Organization SubpartNo
Authorized OfficialWendell O BlakePresident · (863) 683-5567
Enumeration DateOctober 3, 2013
✔ NPI 1700213972 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in FL · ME0016779
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
505 MARTIN LUTHER KING JR AVENUE, Lakeland, FL 33815
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Wendell O Blake MD PA's NPI number?

The NPI number for Wendell O Blake MD PA is 1700213972. It was assigned to this organization in the NPPES registry on October 3, 2013.

Where is Wendell O Blake MD PA located?

Wendell O Blake MD PA is located at 505 Martin Luther King Jr Avenue Suite 2, Lakeland, FL 33815. The listed phone number is (863) 683-5567.

What is Wendell O Blake MD PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Wendell O Blake MD PA was last updated on October 3, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.