Provider Demographics
NPI:1346312436
Name:BLOUNT, HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:BLOUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 VICK RD APT 203
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2837
Mailing Address - Country:US
Mailing Address - Phone:407-509-4032
Mailing Address - Fax:407-291-9599
Practice Address - Street 1:6388 SILVER STAR RD
Practice Address - Street 2:SUITE 2G
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3235
Practice Address - Country:US
Practice Address - Phone:407-291-9500
Practice Address - Fax:407-291-9599
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057537207V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL063531601Medicaid
FLE59056Medicare UPIN
FL063531601Medicaid