Active NPI
Doreen Blischak, PHD, CCC-SLP
- Speech-Language Pathologist
- Melrose, FL
National Provider Identifier
1114916111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA5696
- Practice address
- 309 State Road 26
Melrose, FL 32666-3906 - Phone
- (352) 475-5726
- NPI assigned
- Oct 21, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA5696 | FL | Primary |
Addresses
Primary practice location
309 State Road 26
Melrose, FL 32666-3906
Mailing address
309 State Road 26
Melrose, FL 32666-3906
Phone (352) 475-5726
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA5696 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1114916111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 STATE ROAD 26",
"city": "MELROSE",
"state": "FL",
"postal_code": "326663906",
"telephone_number": "352-475-5726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 STATE ROAD 26",
"city": "MELROSE",
"state": "FL",
"postal_code": "326663906",
"telephone_number": "352-475-5726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLISCHAK",
"first_name": "DOREEN",
"credential": "PHD, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-21",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA5696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melrose, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.