Provider Demographics
NPI:1548392525
Name:BLAQUIER, KARIN V
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:V
Last Name:BLAQUIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1664
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34749-1664
Mailing Address - Country:US
Mailing Address - Phone:352-315-0050
Mailing Address - Fax:352-315-0059
Practice Address - Street 1:310 MARKET ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5135
Practice Address - Country:US
Practice Address - Phone:352-315-0050
Practice Address - Fax:352-315-0059
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT691227900000X
FLHHA299992424163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No163WH0200XNursing Service ProvidersRegistered NurseHome Health