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General NPI Number Information
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NPI Number | 1740474782
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Entity Type | Organization
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Legal Business Name | BLOUT ENTERPRISES INC.
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 3424 MOUNT BERWICK DR
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City | APOPKA
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State | FL
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Zip | 32712-4740
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Country | US
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Telephone | 407-886-6741
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Fax | 407-650-3171
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Provider Business Mailing Address
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Address Line | PO BOX 2225
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City | APOPKA
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State | FL
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Zip | 32704-2225
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Country | US
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Telephone | 407-886-6741
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Fax | 407-650-3171
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ELAINE M. BLOUT
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Credential | RN, CCN, CRRN
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Telephone | 407-252-8790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | WC3000142
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License Number State | FL
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