Active NPI
Eileen M. Blackburn, PA-C
- Medical Physician Assistant
- Sunrise, FL
National Provider Identifier
1790738490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 2181
- Practice address
- 14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865 - Phone
- (800) 424-3672
- Fax
- (954) 377-3042
- NPI assigned
- May 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 2181 | FL | Primary |
Addresses
Primary practice location
14050 NW 14TH St
Suite 190
Sunrise, FL 33323-2865
Mailing address
206 2ND St E
Bradenton, FL 34208-1042
Phone (941) 746-5111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060622000042 | FL | Practitioner - Physician Assistant | 8921010661 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 2181 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine of Florida, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Medicine Clinic/Center
- Tampa, FL
- NPI 1134235872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790738490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 2ND ST E",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342081042",
"telephone_number": "941-746-5111",
"fax_number": "941-745-7206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14050 NW 14TH ST",
"address_2": "SUITE 190",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232865",
"telephone_number": "800-424-3672",
"fax_number": "954-377-3042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "EILEEN",
"middle_name": "M.",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA 2181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.