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1952077117
KENNETH BLISS
PORT CHARLOTTE, FL
NPI
1952077117
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL APRN11012755)
Enumeration Date
2021-08-18
Last Update Date
2021-08-18
Business Address
KENNETH BLISS
21260 OLEAN BLVD STE 202A
PORT CHARLOTTE, FL 33952-6742
Phone number: 941-625-1550
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Mailing Address
KENNETH BLISS
12387 SAGEWOOD DR
VENICE, FL 34293-0327
Phone number: 561-329-6408
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