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

Dr. Danice Blaise, MD, MBA

Individual provider General Practice Physician · NPI 1255829966

Dr. Danice Blaise, MD, MBA is a General Practice in Lake Wales, Florida. Qualified in 2017, 9 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in Florida, Indiana, Missouri and New Hampshire.

Years since qualifying
9
Licensed in
FL, IN, MO, NH
In the registry since
2018
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MBA — Master of Business Administration
A graduate business degree.

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Practice location Address checks out

684 State Road 60 W
Lake Wales, FL 33853-4419
Phone: (863) 949-4868
Fax: (863) 223-8549
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 571 Avenue K Se, Winter Haven, FL 33880-4215 — (407) 440-0708

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence ACN1418 (FL)
Internal Medicine Physician Taxonomy 207R00000X · Licence 25173 (NH)
Physician Assistant Taxonomy 363A00000X · Licence 2019045102 (MO)
Physician Assistant Taxonomy 363A00000X · Licence CV2000213 (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1255829966
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MBA
Sole proprietorYes
NPI enumeratedApril 27, 2018
Last updated in NPPESDecember 7, 2024
Certification dateDecember 7, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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