Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Wendell O Blake MD PA

Organization General Practice Physician · NPI 1700213972

Wendell O Blake MD PA is a General Practice Physician in Lakeland, Florida. Licensed in Florida. Registered with an NPI since 2013.

Licensed in
FL
In the registry since
2013
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

505 Martin Luther King Jr Ave Ste 2
Lakeland, FL 33815-1527
Phone: (863) 683-5567
Fax: (863) 686-5814
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Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ME0016779 (FL)

Record details

NPI number1700213972
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Wendell Blake — President · (863) 683-5567
NPI enumeratedOctober 3, 2013
Last updated in NPPESOctober 3, 2013
Mailing address505 Martin Luther King Jr Avenue, Suite 2, Lakeland, FL 33815-1527

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