Bennett-Blake, Desreen E

Bennett-Blake, Desreen E is an individual health care provider with primary practice located at 7205 S George Blvd , Sebring FL 33875-5847. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Bennett-Blake, Desreen E can be contacted via phone (863) 386-6040.

Contact Information

Primary practice address
7205 S George Blvd Sebring FL 33875-5847
Phone: (863) 386-6040
Fax: (863) 386-6048
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2036402 Florida

Profile Details

NPI number 1831168558
LBN Legal business name Bennett-Blake, Desreen E
Credentials A.R.N.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Dec 16th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831168558 NPPES
Florida MEDICAID 301858500
Florida Other ARNP2036402

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