Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Lee Bertolino

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1477136711

Blake Lee Bertolino is a Student in an Organized Health Care Education/Training Program in Charlotte, North Carolina. Practices as a sole proprietor and works from 2 locations. Licensed in North Carolina.

Licensed in
NC
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Charlotte, NC

No coordinates on file. Search this address in Google Maps

Additional practice locations (1)

  • 2401 W Omaha St Apt 1224, Broken Arrow, OK 74012-0643 — (406) 281-1173

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 2026-04025 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1477136711
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 4, 2021
Last updated in NPPESJuly 21, 2026
Certification dateJuly 21, 2026

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