| Dr Kris M Bly, DO | |
|
2777 Enterprise Rd, Orange City, FL 32763-8310 | |
| (386) 774-2550 | |
| (386) 774-5667 |
| Full Name | Dr Kris M Bly |
|---|---|
| Gender | Female |
| Speciality | General Practice |
| Location | 2777 Enterprise Rd, Orange City, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497700223 | NPI | - | NPPES |
| 02001471B | Other | IN | CSR |
| 17085 | Other | FL | BCBSFL |
| 02001471A | Other | IN | INDIANA LICENSE |
| 0S10451 | Other | FL | FLORIDA LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS10451 (Florida) | Primary |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | OS10451 (Florida) | Secondary |
| Entity Name | Florida Health Care Plan Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558302042 PECOS PAC ID: 9436201233 Enrollment ID: O20090708000537 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kris M Bly, DO 2777 Enterprise Rd, Orange City, FL 32763-8310 Ph: (386) 774-2550 | Dr Kris M Bly, DO 2777 Enterprise Rd, Orange City, FL 32763-8310 Ph: (386) 774-2550 |
Dr. Jeann Marie Maldonado Cintron, M.D. General Practice Medicare: Medicare Enrolled Practice Location: 876 Saxon Blvd, Orange City, FL 32763 Phone: 386-774-0491 Fax: 386-774-0492 | |
Luis Daniel Ramos, MD General Practice Medicare: Medicare Enrolled Practice Location: 1668 S Volusia Ave, Orange City, FL 32763 Phone: 386-668-9831 Fax: 386-668-9841 | |
Dr. Nancy D Ortiz, MD General Practice Medicare: Accepting Medicare Assignments Practice Location: 876 Saxon Blvd, Orange City, FL 32763 Phone: 386-668-9800 | |
Mr. Jay C Chanmugam, DO General Practice Medicare: Accepting Medicare Assignments Practice Location: 1133 Saxon Blvd, Orange City, FL 32763 Phone: 386-228-9700 | |
Dr. Travis Lloyd Herring, M.D. General Practice Medicare: May Accept Medicare Assignments Practice Location: 106 W Fern Dr, Orange City, FL 32763 Phone: 386-775-0525 | |
Dr. Edgar B George, M.D. General Practice Medicare: Accepting Medicare Assignments Practice Location: 938 Saxon Blvd Ste D, Orange City, FL 32763 Phone: 352-259-2159 Fax: 352-259-5731 |