Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. PERTH AGUSTA BLAKE, M.D.
Active Sole ProprietorDR. PERTH AGUSTA BLAKE, M.D. is a Family Medicine healthcare provider located in TAVARES, Florida. NPI 1063505105 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · TAVARES, FL
Registration Details
- NPI Number
- 1063505105
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 2, 2006 (19.865729325278 yrs)
- Last Updated
- Mar 16, 2012
- License
-
ME0069890 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1840 CLASSIQUE LNTAVARES, FL, 327785748Browse FL providers · Browse ZIP 32778
- Phone
- 3525085046
- Fax
- 3525085048
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in TAVARES, FL
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN THOMAS WATSON | M.D. | 1285639047 |
| MARY ANN TESALONA | M.D. | 1396744967 |
| DR. JOSEPH J. BEHAL | MD | 1518945377 |
| DAN ARGIN BOGGUS | MD | 1669419248 |
| CHUONG HOANG VU | MD | 1366484446 |
| KURT B WAGNER | MD | 1548202427 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.