MEDICARE: BLESSED HEALTHCARE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1265232110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED HEALTHCARE CORP

Provider Business Mailing Address
First Line	:	1215 SW 90TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3119
Country	:	US
Telephone Number	:	305-342-2481
Fax Number	:	800-603-8864

Provider Business Practice Location Address
First Line	:	1215 SW 90TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3119
Country	:	US
Telephone Number	:	305-342-2481
Fax Number	:	800-603-8864

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALIETE R NEYRA
Credential	:	APRN
Telephone Number	:	305-342-2481

Provider Enumeration Date	:	03/18/2025
Last Update Date	:	03/18/2025

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Directions to “BLESSED HEALTHCARE CORP ” Practice Location

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