Individual
BYLSMA LEA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1874 SE PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34952-5545
(772) 337-7676
(772) 337-9034
Mailing address
1874 SE PORT ST LUCIE BLVD, PORT SAINT LUCIE, FL 34952-5545
(772) 337-7676
(772) 337-9034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME44211
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10174
BCBS
—
05
—
264254900
—
FL
Enumeration date
06/02/2006
Last updated
06/07/2011
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