Provider Demographics
NPI:1699896464
Name:BLINN, CARMEN ELENA (MD)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:ELENA
Last Name:BLINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11021 SW 93RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-3638
Mailing Address - Country:US
Mailing Address - Phone:305-596-6945
Mailing Address - Fax:305-275-6810
Practice Address - Street 1:11021 SW 93RD CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-3638
Practice Address - Country:US
Practice Address - Phone:305-596-6945
Practice Address - Fax:305-275-6810
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63706207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine