MEDICARE: YADIRA BLANCO LABORI ARNP

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	363LF0000X	Family Nurse Practitioner	APRN9411561	FL

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	:	1972085512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YADIRA BLANCO LABORI ARNP

Provider Business Mailing Address
First Line	:	20013 NW 80TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-6614
Country	:	US
Telephone Number	:	786-319-6697
Fax Number	:

Provider Business Practice Location Address
First Line	:	4218 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-2306
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:	786-558-0242

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

Provider Enumeration Date	:	08/30/2018
Last Update Date	:	11/02/2020

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