Healthcare Provider Details

I. General information

NPI: 1922456573
Provider Name (Legal Business Name): BEATRIZ BLINOV M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 CLINCH AVE
KNOXVILLE TN
37916-2301
US

IV. Provider business mailing address

2018 CLINCH AVE
KNOXVILLE TN
37916-2301
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-8000
  • Fax:
Mailing address:
  • Phone: 865-541-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number39020000X
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberT3746
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number247029
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: