| Wyndal K Blankenship Md | |
|
120 S John Sims Pkwy Valparaiso FL 32580-1212 | |
| (850) 678-6621 | |
| (850) 729-0331 |
| Full Name | Wyndal K Blankenship Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 120 S John Sims Pkwy, Valparaiso, Florida |
| Authorized Official Name and Position | Debbie J Anderson (INS MANAGER) |
| Authorized Official Contact | 8506786621 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyndal K Blankenship Md 120 S John Sims Pkwy Valparaiso FL 32580-1212 Ph: (850) 678-6621 | Wyndal K Blankenship Md 120 S John Sims Pkwy Valparaiso FL 32580-1212 Ph: (850) 678-6621 |
| NPI Number | 1316930571 |
|---|---|
| Provider Enumeration Date | 08/23/2005 |
| Last Update Date | 12/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316930571 | NPI | - | NPPES |
| 256934500 | Medicaid | FL | |
| 46862 | Other | BC NUMBER | |
| N1099 | Other | FL | EDI SENDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Emerald Coast Family Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 143 S John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-729-3300 Fax: 850-729-3100 | |
Donald B. Schak Sr., M.d., Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 S John Sims Pkwy, Suite C, Valparaiso, FL 32580 Phone: 850-678-0061 Fax: 850-678-0068 |