Healthcare Provider Details

I. General information

NPI: 1306356043
Provider Name (Legal Business Name): BLANCA N PILDAIN RCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 SW 99TH AVE STE 102
MIAMI FL
33173-4668
US

IV. Provider business mailing address

16730 SW 301ST ST
HOMESTEAD FL
33030-4911
US

V. Phone/Fax

Practice location:
  • Phone: 305-591-7898
  • Fax:
Mailing address:
  • Phone: 305-282-7103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW18260
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License NumberISW18260
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: