Provider Demographics
NPI:1699031948
Name:BLANDFORD, ALEXANDER D (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:D
Last Name:BLANDFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4511
Mailing Address - Country:US
Mailing Address - Phone:772-299-1404
Mailing Address - Fax:
Practice Address - Street 1:3500 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-299-1404
Practice Address - Fax:772-299-1455
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-11
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.128406207WX0200X
FLME134885207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery