MEDICARE: MARIA QUINTANA BLANCO CBHCMS

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	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator		FL

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	:	1508128752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA QUINTANA BLANCO CBHCMS

Provider Business Mailing Address
First Line	:	5414 GARDEN AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-3516
Country	:	US
Telephone Number	:	561-227-8844
Fax Number	:

Provider Business Practice Location Address
First Line	:	2311 10TH AVE N STE 3
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-6605
Country	:	US
Telephone Number	:	561-899-3017
Fax Number	:	561-429-2622

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

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	06/27/2025

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