Individual
DR. LORI MARIE DEBLASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1645 COLONIAL BLVD, FORT MYERS, FL 33907-1101
(239) 430-3668
(239) 692-9436
Mailing address
730 GOODLETTE RD, STE 102, NAPLES, FL 34102-5617
(239) 430-3668
(239) 692-9436
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
4222
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10790442
CAQH
OH
05
—
2215481
—
OH
01
—
641
SC MEDICAL LICENSE
SC
05
—
PD6416
—
SC
Enumeration date
09/21/2005
Last updated
09/03/2021
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