MEDICARE: CATHERINE MARGARET GREENBLUM PHD, APRN, FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	1790662	FL

General Provider Information

NPI Number	:	1134232820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE MARGARET GREENBLUM PHD, APRN, FNP-BC

Provider Business Mailing Address
First Line	:	276 CENTENNIAL PARK DR
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32124-5102
Country	:	US
Telephone Number	:	904-553-9251
Fax Number	:

Provider Business Practice Location Address
First Line	:	276 CENTENNIAL PARK DR
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32124-5102
Country	:	US
Telephone Number	:	904-553-9251
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	01/08/2025

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