Healthcare Provider Details

I. General information

NPI: 1093525248
Provider Name (Legal Business Name): BELEN MERCEDES BLANCO SALAZAR NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 CITRUS MEDICAL CT # B
OCOEE FL
34761-4547
US

IV. Provider business mailing address

1028 WILLA LAKE CIR
OVIEDO FL
32765-6425
US

V. Phone/Fax

Practice location:
  • Phone: 407-216-2121
  • Fax:
Mailing address:
  • Phone: 407-640-1373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11037932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: