Individual provider · NPI-1

Michael Fred Blackard, DO

Internal Medicine · Ocoee, FL

NPI number1235876616
StatusActive
Last updated in NPPESAug 15, 2025

Details

NPI
1235876616
Entity type
Individual (NPI-1)
Name
Michael Fred Blackard
Credential
DO
Sex
Male
Sole proprietor
No
Enumeration date
May 17, 2022
Certification date
Aug 15, 2025
Last updated
Aug 15, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineOS22533FLYes
390200000X Student in an Organized Health Care Education/Training Program–FL

Practice location

10000 W Colonial Dr Ste 381
Ocoee, FL 34761-3435

Phone 321-841-3467 · Fax 407-253-2563

Mailing address

10000 W Colonial Dr Ste 381
Ocoee, FL 34761-3435

Phone 321-841-3467 · Fax 407-253-2563

Other practice locations

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510

Phone 954-468-4068

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