Most Relevant Information
Provider Data
| NPI Number: | 1003365719 |
| Provider Name: | ABIGAIL BLACKMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/23/2016 |
| Last Updated: | 09/23/2016 |
Provider Practice Location
150 W UNIVERSITY BLVD
MELBOURNE
FL
329016982
Practice Location Phone/Fax
| Phone: | 3216748106 |
| Fax: | 3216748411 |
Provider Mailing Location
150 W UNIVERSITY BLVD
MELBOURNE
FL
329016982
Provider Mailing Phone/Fax
| Phone: | 3216748106 |
| Fax: | 3216748411 |