person
Lisa Ann Blacklidge, PA-C
Surgical Physician Assistant in Bradenton, Florida
NPI 1275596728

Lisa Ann Blacklidge is a Surgical Physician Assistant based in King Of Prussia, FL and is specialized in Surgical. Lisa Ann Blacklidge practices in Bradenton, FL and has the professional credentials of PA-C. The NPI Number for Lisa Ann Blacklidge is 1275596728 and holds a License No. PA9101122 (Florida).

The current practice location address for Lisa Ann Blacklidge is 206 2Nd St E, Bradenton, FL and can be reached out via phone at 941-746-5111 and via fax at 941-745-7233. You can also correspond with Lisa Ann Blacklidge through the mailing address at 367 S. GULPH RD, KING OF PRUSSIA, PA - 19406-3121 (mailing address contact number: 775-356-9393).

Location: 206 2Nd St E, Bradenton, FL, 19406-3121
person
Provider Profile Details
NPI Number
1275596728
Provider Name
Lisa Ann Blacklidge
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
206 2Nd St E, Bradenton, FL, 19406-3121
Phone Number
941-746-5111
Fax Number
941-745-7233
Provider Enumeration Date
04/07/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
015120400 05 FL
970020641 01 RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
206 2Nd St E
City
State
Zip
34208-1042
Phone Number
941-746-5111
Fax Number
941-745-7233
person
Provider Business Mailing Address Details
Address
367 S. Gulph Rd
City
State
Zip
19406-3121
Phone Number
775-356-9393
Fax Number
775-356-5590
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA9101122 (Florida)
Definition
Definition to come...
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