Individual ProviderSirinat BlakeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3152 Little Rd # 162, Trinity, FL 34655-1864(847) 289-5727PECOS EnrollmentBased on the most recent information from CMS, provider Sirinat Blake is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:24 AM.Profile DetailsProvider ID1295405363Provider TypeIndividualFull NameBlake, SirinatTitleMrs.CredentialFNPGenderFemaleSole ProprietorNoEnumeration Date9/20/2021Last Updated9/20/2021Contact InformationPractice LocationPractice Address3152 Little Rd # 162, Trinity, FL 34655-1864Phone(847) 289-5727FaxUnlisted FaxMailing LocationMailing Address3152 Little Rd # 162, Trinity, FL 34655-1864Phone(847) 289-5727FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11013740Florida