MEDICARE: LIANET ESTHER COELLO BLANCO APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11006473	FL

General Provider Information

NPI Number	:	1033748041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANET ESTHER COELLO BLANCO APRN

Provider Business Mailing Address
First Line	:	3514 NW 15TH ST
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-2506
Country	:	US
Telephone Number	:	786-925-7779
Fax Number	:

Provider Business Practice Location Address
First Line	:	2540 WINKLER AVE # 1
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9338
Country	:	US
Telephone Number	:	239-347-0810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	04/21/2026

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