Healthcare Provider Details

I. General information

NPI: 1265232110
Provider Name (Legal Business Name): BLESSED HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 SW 90TH AVE
MIAMI FL
33174-3119
US

IV. Provider business mailing address

1215 SW 90TH AVE
MIAMI FL
33174-3119
US

V. Phone/Fax

Practice location:
  • Phone: 305-342-2481
  • Fax: 800-603-8864
Mailing address:
  • Phone: 305-342-2481
  • Fax: 800-603-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALIETE R NEYRA
Title or Position: PRESIDENT
Credential: APRN
Phone: 305-342-2481