Basic Information
| Provider Information | |||||||||
| NPI: | 1790947935 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLAKEY | ||||||||
| FirstName: | BRITTONY | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3830 BEE RIDGE RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342331105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419275178 | ||||||||
| FaxNumber: | 9419216838 | ||||||||
| Practice Location | |||||||||
| Address1: | 6106 STATE ROAD 70 E | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342039712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9419275178 | ||||||||
| FaxNumber: | 9419216838 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 07/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | OS17689 | FL | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.