OrganizationActive
Cityblock Medical Practice La, LLC
NPI 1790447373 · General Practice Physician · Lafayette, LA
Provider details
- NPI number
- 1790447373
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Devon Minerve, Corporate Counsel(202) 321-2528
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1042 Camellia Blvd
Lafayette, LA 70508-6680
Phone: (800) 336-1100
Approximate (ZIP-level) locationGet directions
Mailing address
495 Flatbush Ave Ste C5
Brooklyn, NY 11225-3706
Registry dates
- Enumerated
- 2021-10-11
- Last updated
- 2021-10-11
- Certified
- 2021-10-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.