Bly, Kris M
Bly, Kris M is an individual health care provider with primary practice located at 2777 Enterprise Rd , Orange City FL 32763-8310. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Bly, Kris M can be contacted via phone (386) 774-2550.Contact Information
Primary practice address
2777 Enterprise Rd
Orange City FL 32763-8310
Phone: (386) 774-2550
Fax: (386) 774-5667
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | OS10451 | Florida |
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | OS10451 | Florida |
Profile Details
| NPI number | 1497700223 |
|---|---|
| LBN Legal business name | Bly, Kris M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Oct 12th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497700223 | NPPES |
| Indiana | Other | 02001471B | CSR |
| Indiana | Other | 17085 | CSR |
| Indiana | Other | 02001471A | CSR |
| Indiana | Other | 0S10451 | CSR |
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