Search › Florida › 101YA0400X
Justin Blackwell, CAP, ICADC, CAC-AD
NPI 1871011486 · on the registry since 2017
Practice
- Address
- 1415 Homestead Rd N
Lehigh Acres, FL 33936 - Phone
- (239) 491-8092
- Fax
- (239) 491-9213
- Clinicians at this address
- 5
Additional practice sites
- 600 Sw 18th Ter, Cape Coral, FL
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Also registered as
- 101YA0400X
101YA0400X
175T00000X - Licence states on file
- FL, MD
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-05-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida