| Lisa Blas, PT | |
|
450077 State Road 200, Callahan, FL 32011-3863 | |
| (904) 980-0119 | |
| (904) 879-9541 |
| Full Name | Lisa Blas |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 450077 State Road 200, Callahan, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902916216 | NPI | - | NPPES |
| 9390538 | Other | NY | IHA |
| 00025703502 | Other | UNIVERA | |
| 000625539003 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 017317 (New York) | Secondary |
| 225100000X | Physical Therapist | PT017089 (Georgia) | Secondary |
| 225100000X | Physical Therapist | PT41361 (Florida) | Primary |
| Provider Name | Advance Rehabilitation & Consulting Limited Partnership |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1235434283 PECOS PAC ID: 4082890645 Enrollment ID: O20110609000322 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Blas, PT 450077 State Road 200, Callahan, FL 32011-3863 Ph: (904) 980-0119 | Lisa Blas, PT 450077 State Road 200, Callahan, FL 32011-3863 Ph: (904) 980-0119 |
Juan Avelino, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 45390 Green Ave, Callahan, FL 32011 Phone: 904-879-1223 | |
Dr. William Patrick Gaffigan Iii, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 45390 Green Ave, Callahan, FL 32011 Phone: 904-879-1223 | |
Miss Bayley Marsh, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 450077 State Road 200 Ste 9, Callahan, FL 32011 Phone: 904-872-2004 | |
Christine M Lefko, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 45390 Green Ave, Callahan, FL 32011 Phone: 904-879-1223 Fax: 904-879-4986 | |
Lisa Hall, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 45390 Green Ave, Callahan, FL 32011 Phone: 904-879-1223 Fax: 907-879-4986 | |
Ryan Redwine, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 45390 Green Ave, Callahan, FL 32011 Phone: 904-879-1223 Fax: 904-879-4986 | |
Juan Esparza, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 45390 Green Ave, Callahan, FL 32011 Phone: 904-879-1223 |