Individual
DR. RAFAEL WILLIAM BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
3402 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6214
(813) 875-3950
(813) 876-0432
Mailing address
PO BOX 102222, ATTN: CREDENTIAL DEPARTMENT, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME30523
FL
207RX0202X
Medical Oncology Physician
Primary
ME30523
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069575100
—
FL
01
—
62236
BLUE CROSS BLUE SHIELD
FL
01
—
P00679540
RR MEDICARE
FL
Enumeration date
05/16/2006
Last updated
03/24/2026
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