Healthcare Provider Details

I. General information

NPI: 1346248846
Provider Name (Legal Business Name): HOWARD STEVEN BLANK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7079 CORNING CIR
BOYNTON BEACH FL
33437-3985
US

IV. Provider business mailing address

7079 CORNING CIR
BOYNTON BEACH FL
33437-3985
US

V. Phone/Fax

Practice location:
  • Phone: 561-734-1236
  • Fax: 253-595-5571
Mailing address:
  • Phone: 561-734-1236
  • Fax: 253-595-5571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number105924
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD 116258
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: