Mosi Blake, L/ATC
Specialist/Technologist, Athletic Trainer in Brandon, FL. Individual provider (NPI-1).
NPI number1336656263
StatusActive
Last updated in NPPESApr 22, 2021
Details
- NPI
- 1336656263
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mosi Blake
- Credential
- L/ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 31, 2017
- Certification date
- Apr 22, 2021
- Last updated
- Apr 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL2928 | FL | Yes |
Practice location
305 E Brandon BlvdBrandon, FL 33511-5222
Phone 813-978-9700 · Fax 813-558-6187
Mailing address
13020 N Telecom PkwyTemple Terrace, FL 33637-0925
Phone 813-978-9700 · Fax 813-558-6187
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All 14 Athletic Trainer providers in Brandon · All 4,834 providers in Brandon
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