Provider Demographics
NPI:1447318274
Name:BLUME, GARY B (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:B
Last Name:BLUME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:700 8TH AVE W STE 101
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-4737
Mailing Address - Country:US
Mailing Address - Phone:941-776-4000
Mailing Address - Fax:941-845-4963
Practice Address - Street 1:220 N TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-5229
Practice Address - Country:US
Practice Address - Phone:941-366-0800
Practice Address - Fax:941-366-1102
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025519207Q00000X
FLME115126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14PM2OtherBCBS
WA366524OtherLABOR & INDUSTRIES
WA1033606Medicaid
FL008419600Medicaid
WA8109357Medicaid
WA8109357Medicaid