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General NPI Number Information
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NPI Number | 1326511395
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Entity Type | Individual
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Provider Name | ROBERTO CARLOS BLANCO DNP, CRNA, ARNP
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Gender | Male
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 1400 NW 12TH AVE STE 75
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City | MIAMI
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State | FL
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Zip | 33136-1003
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Country | US
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Telephone | 305-689-5792
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Fax | 305-689-1089
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Provider Business Mailing Address
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Address Line | 14470 SW 162ND ST
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City | MIAMI
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State | FL
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Zip | 33177-1714
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Country | US
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Telephone | 786-219-6240
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN9275537
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11000864
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0131254
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9275537
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN9275537
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License Number State | FL
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