Provider Demographics
NPI:1174083901
Name:BLAY, GEORGINA (MD)
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:BLAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GEORGETTE
Other - Middle Name:FREMPOMA
Other - Last Name:APPIAH-PIPPIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9655 NW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2973
Mailing Address - Country:US
Mailing Address - Phone:054-361-5633
Mailing Address - Fax:
Practice Address - Street 1:9655 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2973
Practice Address - Country:US
Practice Address - Phone:305-436-1563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME154929208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113779800Medicaid