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NPI Code Detail

MEDICARE: JOSE A. BLANCO-POLANCO CRNA

MEDICARE: JOSE A. BLANCO-POLANCO CRNA
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
1367500000XCertified Registered Nurse AnesthetistARNP9193364FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G3176OTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982621843
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSE A. BLANCO-POLANCO CRNA
Provider Business Mailing Address
First Line : PO BOX 4918
Second Line :
City : ORLANDO
State : FL
Zip : 32802-4918
Country : US
Telephone Number : 407-581-9180
Fax Number : 865-560-7066
Provider Business Practice Location Address
First Line : 225 E ROBINSON ST
Second Line : SUITE 130
City : ORLANDO
State : FL
Zip : 32801-4322
Country : US
Telephone Number : 407-581-9180
Fax Number : 865-560-7066
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 12/21/2016

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Directions to “ JOSE A. BLANCO-POLANCO CRNA” Practice Location

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