Healthcare Provider Details

I. General information

NPI: 1679125751
Provider Name (Legal Business Name): TANIA ISABEL RIERA BLANCO CBHCM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S ROYAL POINCIANA BLVD APT 109
MIAMI SPRINGS FL
33166-7361
US

IV. Provider business mailing address

801 S ROYAL POINCIANA BLVD APT 109
MIAMI SPRINGS FL
33166-7361
US

V. Phone/Fax

Practice location:
  • Phone: 786-454-6570
  • Fax:
Mailing address:
  • Phone: 786-454-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11048376
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: