Healthcare Provider Details

I. General information

NPI: 1285576363
Provider Name (Legal Business Name): CASSANDRA BLANCO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 S MILITARY TRL STE D
WEST PALM BEACH FL
33415-4698
US

IV. Provider business mailing address

1718 N D ST
LAKE WORTH BEACH FL
33460-6412
US

V. Phone/Fax

Practice location:
  • Phone: 561-328-8312
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: