Danice Blaise, MD,MBA
Danice Blaise, MD,MBA is a General Practice Physician in Lake Wales, FL, registered under NPI 1255829966. This provider registers 4 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 684 STATE ROAD 60 W, Lake Wales, FL 33853. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| ACN1418 | FL | General Practice Physician primary |
| 25173 | NH | Internal Medicine Physician |
| 2019045102 | MO | Physician Assistant |
| CV2000213 | IN | Physician Assistant |
Licences are recorded in 4 states: FL, NH, MO, IN. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - General Practice
- PAC ID
- 1355738899
Medicare enrolment is recorded as approved under the provider type Practitioner - General Practice. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 4 states
This provider holds licences in 4 states: Florida, Indiana, Missouri and New Hampshire. The practice address on file is in Lake Wales, FL, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- ACN1418
- Specialty
- General Practice Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What General Practice covers
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. NUCC Health Care Provider Taxonomy, code 208D00000X
All registered taxonomy codes
This provider registers 5 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 208D00000X | General Practice Physician | ACN1418 | FL | primary |
| 207R00000X | Internal Medicine Physician | 25173 | NH | |
| 363A00000X | Physician Assistant | 2019045102 | MO | |
| 363A00000X | Physician Assistant | CV2000213 | IN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1255829966 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 27, 2018 |
| Last updated | Dec 7, 2024 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | MD,MBA |
| Practice address |
684 STATE ROAD 60 W Lake Wales, FL 33853 (863) 949-4868 Fax (863) 223-8549 |
| Mailing address |
6675 WESTWOOD BLVD STE 475 Orlando, FL 32821 |
| Other identifiers |
115752400
(FL) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 2 | 5 | 5 | 8 | 2 | 9 | 9 | 6 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 2 | 1 | 5 | 7 | 2 | 9 | 9 | 3 |
Sum = 64 · next multiple of 10 = 70 · check digit = 6 · actual last digit = 6
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.