Blackfin Medical

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

BLACKFIN MEDICAL

Practice address

6415 Lake Worth Rd Ste 102
Greenacres, FL 33463-3009

Phone

(561) 331-0808

Fax

(561) 237-6034

NPI assigned

Dec 5, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bradford George Peters

Title

Ceo

Phone

(561) 331-0808

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1174093959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 LAKE WORTH RD STE 102",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633009",
            "telephone_number": "561-331-0808",
            "fax_number": "561-331-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 LAKE WORTH RD STE 102",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633009",
            "telephone_number": "561-331-0808",
            "fax_number": "561-237-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKFIN MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-331-0808"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethesda Assisted Living
• Charlotte Bartow Bianco, M.S., CCC-SLP
• Big Smile Dentistry II, Inc.
• Khemwattie Bipram
• BKW - Greenacres Asset Management Company
• Maria Blanco de Carrasco
• Catherine Blanco
• Sebastien Bleau, DMD
• Karie Ann Bliss, LMHC
• Debra Ann Blizzard, LMHC

• Supports Brokerage Agency in Greenacres, FL
• Providers in Greenacres, FL by specialty
• Supports Brokerage Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.