MEDICARE: YAIMEL GARCIA BLANCO FNP

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	207Q00000X	Family Medicine Physician	F02230243	FL

General Provider Information

NPI Number	:	1194423764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAIMEL GARCIA BLANCO FNP

Provider Business Mailing Address
First Line	:	4444 SW 67TH AVE APT 11
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-5826
Country	:	US
Telephone Number	:	305-484-6280
Fax Number	:

Provider Business Practice Location Address
First Line	:	4444 SW 67TH AVE APT 11
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-5826
Country	:	US
Telephone Number	:	305-484-6280
Fax Number	:

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

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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