Provider Demographics
NPI:1639533698
Name:BLITSTEIN, JOSHUA (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BLITSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 9TH ST N
Mailing Address - Street 2:STE 308
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5627
Mailing Address - Country:US
Mailing Address - Phone:239-643-7888
Mailing Address - Fax:239-643-4744
Practice Address - Street 1:599 9TH ST N
Practice Address - Street 2:STE 308
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5627
Practice Address - Country:US
Practice Address - Phone:239-643-7888
Practice Address - Fax:239-643-4744
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT018169207Q00000X
390200000X
FLOS16394207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program