MEDICARE: BLESSING UPON BLESSING

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1790455574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSING UPON BLESSING

Provider Business Mailing Address
First Line	:	53 MALLARD AVE NE
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-4926
Country	:	US
Telephone Number	:	850-428-9338
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 MALLARD AVE NE
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32548-4926
Country	:	US
Telephone Number	:	850-428-9338
Fax Number	:

Authorized Official
Title or Position	:	HOMEHEALTH CARE
Name	:	ROBIN L MCNEALY
Credential	:
Telephone Number	:	850-428-9338

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	09/14/2021

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Directions to “BLESSING UPON BLESSING ” Practice Location

Language	Start Address	Practice Location

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