Blaise, Danice
Blaise, Danice is an sole proprietor health care provider with primary practice located at 684 State Road 60 W , Lake Wales FL 33853-4419. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Blaise, Danice can be contacted via phone (863) 949-4868.Contact Information
Primary practice address
684 State Road 60 W
Lake Wales FL 33853-4419
Phone: (863) 949-4868
Fax: (863) 223-8549
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | ACN1418 | Florida |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25173 | New Hampshire |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2019045102 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | CV2000213 | Indiana |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1255829966 |
|---|---|
| LBN Legal business name | Blaise, Danice |
| Credentials | MD,MBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 27th, 2018 |
| Last updated | Dec 7th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255829966 | NPPES |
| Florida | MEDICAID | 115752400 |
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