| Dr Kenneth Blaze Pa And Associates | |
|
1 Sw 129th Ave Suite 109 Pembroke Pines FL 33027-1761 | |
| (954) 433-4200 | |
| (954) 433-7710 |
| Full Name | Dr Kenneth Blaze Pa And Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Sw 129th Ave, Pembroke Pines, Florida |
| Authorized Official Name and Position | Manuel D Gonzalez (MD) |
| Authorized Official Contact | 9544334200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kenneth Blaze Pa And Associates 1 Sw 129th Ave Suite 109 Pembroke Pines FL 33027-1761 Ph: (954) 433-4200 | Dr Kenneth Blaze Pa And Associates 1 Sw 129th Ave Suite 109 Pembroke Pines FL 33027-1761 Ph: (954) 433-4200 |
| NPI Number | 1932250297 |
|---|---|
| Provider Enumeration Date | 01/15/2007 |
| Last Update Date | 12/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932250297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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