Individual
ELLIOT BLAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
311 9TH ST N STE 200, NAPLES, FL 34102-5887
(239) 624-1160
(239) 624-1161
Mailing address
PO BOX 26067, SALT LAKE CITY, UT 84126-0067
(239) 624-0400
(239) 624-0401
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME147159
FL
390200000X
Student in an Organized Health Care Education/Training Program
ML60569414
WA
390200000X
Student in an Organized Health Care Education/Training Program
TRN20137
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108118800
—
FL
01
—
Z3W7E
BCBS
FL
Enumeration date
06/30/2014
Last updated
03/24/2021
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