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NPI Code Detail

MEDICARE: MARLON BLANCO

MEDICARE: MARLON BLANCO
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
1363LA2200XAdult Health Nurse PractitionerAPRN9250137FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093068090
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLON BLANCO
Provider Business Mailing Address
First Line : 8333 NW 53RD ST FL 6
Second Line :
City : DORAL
State : FL
Zip : 33166-4783
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6517 TAFT ST
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33024-4062
Country : US
Telephone Number : 305-282-4063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2012
Last Update Date : 06/03/2026

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Directions to “ MARLON BLANCO ” Practice Location

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