Provider Demographics
NPI:1306382569
Name:BLANEY, RENEE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:MARIE
Last Name:BLANEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 SE 89TH LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-9347
Mailing Address - Country:US
Mailing Address - Phone:352-804-7204
Mailing Address - Fax:
Practice Address - Street 1:1833 SE 89TH LN
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-9347
Practice Address - Country:US
Practice Address - Phone:352-804-7204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist