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General NPI Number Information
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NPI Number | 1831087246
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Entity Type | Individual
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Provider Name | ADELDA BLANC
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 6000 GLADES RD STE 1032C
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City | BOCA RATON
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State | FL
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Zip | 33431-7259
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Country | US
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Telephone | 561-612-4882
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Fax |
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Provider Business Mailing Address
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Address Line | 224 NW 45TH AVE
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City | PLANTATION
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State | FL
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Zip | 33317-3126
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Country | US
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Telephone | 954-200-0281
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC6723
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License Number State | FL
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