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Individual

KRIS M BLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2777 ENTERPRISE RD, ORANGE CITY, FL 32763-8310
(386) 774-2550
(386) 774-5667
Mailing address
2777 ENTERPRISE RD, ORANGE CITY, FL 32763-8310
(386) 774-2550
(386) 774-5667

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
OS10451
FL
208D00000X
General Practice Physician
Primary
OS10451
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02001471A
INDIANA LICENSE
IN
01
02001471B
CSR
IN
01
0S10451
FLORIDA LICENCE
FL
01
17085
BCBSFL
FL
Enumeration date
05/23/2006
Last updated
03/27/2026
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