Provider Demographics
NPI:1477517381
Name:BLENKE, ANNE M (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:BLENKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1800 N FEDERAL HWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1034
Mailing Address - Country:US
Mailing Address - Phone:954-782-0010
Mailing Address - Fax:954-781-2139
Practice Address - Street 1:1800 N FEDERAL HWY
Practice Address - Street 2:SUITE 104
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1034
Practice Address - Country:US
Practice Address - Phone:954-782-0010
Practice Address - Fax:954-781-2139
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2013-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME08073207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065655100Medicaid
FL065655100Medicaid
FL06441CMedicare PIN