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NPI Code Detail

MEDICARE: CARLA VEGA BLOUIN LCSW

MEDICARE: CARLA VEGA BLOUIN LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW12395FL

General Provider Information

NPI Number : 1023300852
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLA VEGA BLOUIN LCSW
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line :
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 6420 W NEWBERRY RD STE 100
Second Line :
City : GAINESVILLE
State : FL
Zip : 32605-6622
Country : US
Telephone Number : 352-332-3900
Fax Number : 352-332-5009
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2011
Last Update Date : 04/08/2025

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Directions to “ CARLA VEGA BLOUIN LCSW” Practice Location

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