Provider Demographics
NPI:1407141039
Name:BLIX, ANDREW D (ARNP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:BLIX
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 S OSPREY AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2900
Mailing Address - Country:US
Mailing Address - Phone:941-366-9060
Mailing Address - Fax:941-953-7076
Practice Address - Street 1:1425 S OSPREY AVE
Practice Address - Street 2:STE 1
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2900
Practice Address - Country:US
Practice Address - Phone:941-366-9060
Practice Address - Fax:941-953-7076
Is Sole Proprietor?:No
Enumeration Date:2011-06-11
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9324621363LF0000X
FLRN9324621163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8I2KKOtherBCBS FL
FL017888800Medicaid