MEDICARE: ELIZABETH BLASI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	342731	NY
2	363LF0000X	Family Nurse Practitioner	F3427311	NY
3	363LF0000X	Family Nurse Practitioner	APRN11032065	FL

General Provider Information

NPI Number	:	1861989535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BLASI

Provider Business Mailing Address
First Line	:	4335 WATERFORD LANDING DR
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-9727
Country	:	US
Telephone Number	:	585-355-5282
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 S HABANA AVE STE 160
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4190
Country	:	US
Telephone Number	:	813-708-8346
Fax Number	:	866-270-9831

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2018
Last Update Date	:	05/16/2024

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Directions to “ ELIZABETH BLASI ” Practice Location

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