Individual
SUZANNE RAVITA BLACKBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNFA
Contact information
Practice address
7897 SAINT ANDREWS CIR, ORLANDO, FL 32835-8170
(407) 445-0215
(407) 445-0287
Mailing address
7897 SAINT ANDREWS CIR, ORLANDO, FL 32835-8170
(407) 445-0215
(407) 445-0287
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN3314902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310681100
—
FL
01
—
Y7505
BCBS OF FLORIDA
FL
Enumeration date
03/27/2013
Last updated
03/27/2013
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