Provider Demographics
NPI:1740474782
Name:BLOUT ENTERPRISES INC.
Entity type:Organization
Organization Name:BLOUT ENTERPRISES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLOUT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CCN, CRRN
Authorized Official - Phone:407-252-8790
Mailing Address - Street 1:PO BOX 2225
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32704-2225
Mailing Address - Country:US
Mailing Address - Phone:407-886-6741
Mailing Address - Fax:407-650-3171
Practice Address - Street 1:3424 MOUNT BERWICK DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-4740
Practice Address - Country:US
Practice Address - Phone:407-886-6741
Practice Address - Fax:407-650-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLWC3000142251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management