Individual
MS. THERESA BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3801 NW 20TH AVE, OCALA, FL 34475-3400
(352) 216-9222
Mailing address
3801 NW 20TH AVE, OCALA, FL 34475-3400
(352) 216-9222
(352) 629-5907
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9117564
FL
Other
Enumeration date
10/31/2021
Last updated
11/03/2023
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