Individual
MS. EILEEN M. BLACKBURN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Mailing address
206 2ND ST E, BRADENTON, FL 34208-1042
(941) 746-5111
(941) 745-7206
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 2181
FL
Other
Enumeration date
05/17/2006
Last updated
07/08/2007
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