Individual provider Active NPI

Elizabeth Blake, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Wellington, FL
National Provider Identifier
1780076224
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
1154532 Issued in FL
Practice address
9314 Forest Hill Blvd Ste 204
Wellington, FL 33411-6577
Phone
(561) 213-4944
Fax
(561) 964-0035
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 1154532 FL Primary

Addresses

Primary practice location

9314 Forest Hill Blvd Ste 204
Wellington, FL 33411-6577

Mailing address

9314 Forest Hill Blvd Ste 204
Wellington, FL 33411-6577
Phone (561) 213-4944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1154532FLMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1780076224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9314 FOREST HILL BLVD STE 204",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334116577",
            "telephone_number": "561-213-4944",
            "fax_number": "561-964-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 FOREST HILL BLVD STE 204",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334116577",
            "telephone_number": "561-213-4944",
            "fax_number": "561-964-0035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ELIZABETH",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "FL",
            "license": "1154532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; 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.