Healthcare Provider Details

I. General information

NPI: 1396682498
Provider Name (Legal Business Name): RICHARD CELESTINO BIANCHI RN CCM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICARDO BIANCHI RN CCM

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 BEGONIA TER
PARRISH FL
34219-9265
US

IV. Provider business mailing address

148 BEGONIA TER
PARRISH FL
34219-9265
US

V. Phone/Fax

Practice location:
  • Phone: 941-773-5284
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9252701
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: