Bruce Blackwell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME57535 Issued in FL

Practice address

4137 Hunters Park LN
Orlando, FL 32837-7669

Phone

(407) 304-1710

Fax

(407) 304-1778

NPI assigned

Oct 20, 2005

Last updated

May 9, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Care of Central Florida, PA

  • Family Medicine Physician
  • Kissimmee, FL
  • NPI 1477598167
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304899200000",
    "number": "1750370862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 522468",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327522468",
            "telephone_number": "407-389-5300",
            "fax_number": "407-389-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4137 HUNTERS PARK LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328377669",
            "telephone_number": "407-304-1710",
            "fax_number": "407-304-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "BRUCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME57535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Blackman
• Shannon Luv Blackmer Robinson, APRN
• Tori Blackshear, BA
• Mackenzie Michaels Blackstock, DO
• John Michael Blackston, LMHC
• Christopher Wright Blackwell, PHD, ARNP-C
• Melanie Ellen Blackwell, MA,LMHC,NCC
• Megan Blade
• Pamela Jiselle Blade, O.D.
• Jessica Marie Blades, LMHC

• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.