Provider Demographics
NPI:1518029230
Name:BLAHNIK, EMMETT ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:EMMETT
Middle Name:ANDREW
Last Name:BLAHNIK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25749 US HIGHWAY 19 N STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-2004
Mailing Address - Country:US
Mailing Address - Phone:855-724-6727
Mailing Address - Fax:
Practice Address - Street 1:25749 US HIGHWAY 19 N STE 100
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-2004
Practice Address - Country:US
Practice Address - Phone:855-724-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH138972081P2900X, 202D00000X
IL038-0118862081P2900X, 111NR0400X
WI4247-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000015023OtherMEDICARE PTAN
WI000015023OtherMEDICARE PTAN