MEDICARE: BLANCA N PILDAIN RCSWI

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	253Z00000X	In Home Supportive Care Agency
2	1041C0700X	Clinical Social Worker	ISW18260	FL
3	171W00000X	Contractor	ISW18260	FL
4	106S00000X	Behavior Technician

Other Identifiers

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

General Provider Information

NPI Number	:	1306356043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLANCA N PILDAIN RCSWI

Provider Business Mailing Address
First Line	:	16730 SW 301ST ST
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33030-4911
Country	:	US
Telephone Number	:	305-282-7103
Fax Number	:

Provider Business Practice Location Address
First Line	:	7100 SW 99TH AVE STE 102
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33173-4668
Country	:	US
Telephone Number	:	305-591-7898
Fax Number	:

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

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	11/05/2025

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