NPIMap

Organization Active NPI

Steve Blicblum M D P a

  • Anesthesiology Physician
  • Lakeland, FL
National Provider Identifier
1467525303
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
STEVE BLICBLUM M D P A
Practice address
900 Griffin Rd
Lakeland, FL 33805-2442
Phone
(863) 686-1711
Fax
(813) 681-5403
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Illene Blicblum
Title
Group Administrator
Phone
(813) 685-5459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

900 Griffin Rd
Lakeland, FL 33805-2442

Mailing address

PO Box 852
Brandon, FL 33509-0852
Phone (813) 685-5459

National Provider Directory

National Provider Directory
Tax ID family
Steve Blicblum M D P a2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467525303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 852",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335090852",
            "telephone_number": "813-685-5459",
            "fax_number": "813-681-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 GRIFFIN RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338052442",
            "telephone_number": "863-686-1711",
            "fax_number": "813-681-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE BLICBLUM M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLICBLUM",
        "authorized_official_first_name": "ILLENE",
        "authorized_official_title_or_position": "GROUP ADMINISTRATOR",
        "authorized_official_telephone_number": "813-685-5459",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.