Healthcare Provider Details

I. General information

NPI: 1356289805
Provider Name (Legal Business Name): BLAIN WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 W 37TH ST STE 308
HIALEAH FL
33012-4692
US

IV. Provider business mailing address

1651 W 37TH ST STE 308
HIALEAH FL
33012-4692
US

V. Phone/Fax

Practice location:
  • Phone: 786-383-2443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA BLAIN-MAIZA
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 786-383-2443