Blake Dixon (NPI# 1518316702, PAC ID# 7315295854) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1518316702 |
| PAC ID by PECOS | 7315295854 |
| Professional Enrollment ID | I20181016001324 |
| Full Name | Blake Dixon |
| Organization Legal Name | BAYFRONT HMA CONVENIENT CARE LLC |
| Address |
7000 4th N St Saint Petersburg FL 33702-5903 |
| Phone Number | 7275263627 |
| Gender | M |
| Graduation Year | 2016 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 1456597244 |
| Number of Group Practice Members | 13 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100032 | BAYFRONT HEALTH - ST PETERSBURG |
| Address | Phone | Organization |
|---|---|---|
| 3251 66th N St, Saint Petersburg, FL 33710-1510 | 7273443627 | BAYFRONT HMA CONVENIENT CARE LLC |
| 7000 4th N St, Saint Petersburg, FL 33702-5903 | 7275263627 | BAYFRONT HMA CONVENIENT CARE LLC |
| Organization Legal Name | BAYFRONT HMA CONVENIENT CARE LLC |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Altaf G Anga | Family Medicine | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Ronald Glen Boulware | Family Medicine | Bayfront Hma Convenient Care LLC | 3251 66th N St, Saint Petersburg, FL 33710-1510 |
| Patricia A Catallo | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 1550 Pasadena S Ave, South Pasadena, FL 33707-3718 |
| Nicole Jones | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 3251 66th N St, Saint Petersburg, FL 33710-1510 |
| Antwan Edward Lacy | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Erin N Gwyn | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Liyu Liu | Family Medicine | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Kellen Gower | Family Practice | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| James E O Brien | Family Practice | Bayfront Hma Convenient Care LLC | 3251 66th N St, Saint Petersburg, FL 33710-1510 |
| Melanie R Cross | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 3251 66th N St, Saint Petersburg, FL 33710-1510 |
| Street Address |
7000 4TH N ST |
| City | SAINT PETERSBURG |
| State | FL |
| Zip | 33702-5903 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Altaf G Anga | Family Medicine | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Antwan Edward Lacy | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Erin N Gwyn | Nurse Practitioner | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Liyu Liu | Family Medicine | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Kellen Gower | Family Practice | Bayfront Hma Convenient Care LLC | 7000 4th N St, Saint Petersburg, FL 33702-5903 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas G Quinlan | Psychologist, Clinical | 8479 Dr Mlk Jr St N, St Petersburg, FL 33702 | |
| Eden's Valentin | Internal Medicine | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Felipe A Alvarado Amado | Internal Medicine | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Kantilal N Bhadja | Internal Medicine | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Ruperl C Patel | Family Medicine | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Anne C Thorne-picard | Nurse Practitioner | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Nora Koziel | Nurse Practitioner | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Bina Jain | Internal Medicine | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Babette Merchand Pachence | Internal Medicine | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Denise Tatem | Nurse Practitioner | Optumcare Florida, LLC | 10051 5th St N, Suite 200, St Petersburg, FL 33702-2211 |
| Find all physicians in zip 33702 | |||
| City | SAINT PETERSBURG |
| Zip Code | 33702 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | SAINT PETERSBURG + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Blake Dixon.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.