MEDICARE: RACHEL BLANTON

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	367500000X	Certified Registered Nurse Anesthetist	APRN9198439	FL

General Provider Information

NPI Number	:	1285057851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BLANTON

Provider Business Mailing Address
First Line	:	4973 SW 158TH WAY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-5606
Country	:	US
Telephone Number	:	850-528-1162
Fax Number	:

Provider Business Practice Location Address
First Line	:	11011 SHERIDAN ST STE 106
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33026-1501
Country	:	US
Telephone Number	:	954-435-0101
Fax Number	:	954-435-0125

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

Provider Enumeration Date	:	02/01/2014
Last Update Date	:	05/22/2024

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Directions to “ RACHEL BLANTON ” Practice Location

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