Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Blake Ernesto Carrillo, PA-C

Individual provider Medical Physician Assistant · NPI 1588098040

Blake Ernesto Carrillo, PA-C is a Medical Physician Assistant in Miami, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2013
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

14150 SW 136th St
Miami, FL 33186-5506
Phone: (786) 204-4600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14100 Sw 136th St, Miami, FL 33186-5506 — (786) 204-4600

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9107380 (FL)

Record details

NPI number1588098040
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 2, 2013
Last updated in NPPESApril 28, 2020
Certification dateApril 28, 2020

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