Individual ProviderSheila BlakeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7620 Lake Underhill Rd, Orlando, FL 32822-8223(321) 235-0692PECOS EnrollmentBased on the most recent information from CMS, provider Sheila Blake does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1992265979Provider TypeIndividualFull NameBlake, SheilaCredentialAPRNGenderFemaleSole ProprietorNoEnumeration Date3/25/2019Last Updated3/25/2019Contact InformationPractice LocationPractice Address7620 Lake Underhill Rd, Orlando, FL 32822-8223Phone(321) 235-0692Fax(321) 235-0694Mailing LocationMailing Address7620 Lake Underhill Rd, Orlando, FL 32822-8223Phone(321) 235-0692Fax(321) 235-0694Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN9336942FloridaProvider IdentifiersIDDescriptionIssuerIDAPRN9336942DescriptionOtherIssuerLICENSE NUMBERFlorida