MEDICARE: PAULA BLANCO PANDO CRNA

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	367500000X	Certified Registered Nurse Anesthetist	0024168157	VA
2	367500000X	Certified Registered Nurse Anesthetist	ARNP9256888	FL
3	367500000X	Certified Registered Nurse Anesthetist	AP116346	TX
4	367500000X	Certified Registered Nurse Anesthetist	3144	SC
5	163W00000X	Registered Nurse	RN680312	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679532915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA BLANCO PANDO CRNA

Provider Business Mailing Address
First Line	:	PO BOX 918025
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32891-8025
Country	:	US
Telephone Number	:	800-642-1999
Fax Number	:	248-646-0361

Provider Business Practice Location Address
First Line	:	805 PAMPLICO HWY
Second Line	:
City	:	FLORENCE
State	:	SC
Zip	:	29505-6019
Country	:	US
Telephone Number	:	800-642-1999
Fax Number	:	248-646-0361

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/26/2026

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Directions to “ PAULA BLANCO PANDO CRNA” Practice Location

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