Healthcare Provider Details

I. General information

NPI: 1013846914
Provider Name (Legal Business Name): MARILEIDYS BLANCO SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

773 NW 33RD AVE
MIAMI FL
33125-3915
US

IV. Provider business mailing address

773 NW 33RD AVE
MIAMI FL
33125-3915
US

V. Phone/Fax

Practice location:
  • Phone: 786-881-0290
  • Fax:
Mailing address:
  • Phone: 786-881-0290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-479757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: