Healthcare Provider Details

I. General information

NPI: 1518029230
Provider Name (Legal Business Name): EMMETT ANDREW BLAHNIK DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2006
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25749 US HIGHWAY 19 N STE 100
CLEARWATER FL
33763-2004
US

IV. Provider business mailing address

25749 US HIGHWAY 19 N STE 100
CLEARWATER FL
33763-2004
US

V. Phone/Fax

Practice location:
  • Phone: 855-724-6727
  • Fax:
Mailing address:
  • Phone: 855-724-6727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number038-011886
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4247-012
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCH13897
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberCH13897
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number038-011886
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: