Individual
DR. ANTONIO E BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30334 OLD DIXIE HWY, HOMESTEAD, FL 33033-3215
(786) 243-0149
(786) 243-2612
Mailing address
30334 OLD DIXIE HWY, HOMESTEAD, FL 33033-3215
(786) 243-0149
(786) 243-2612
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0057421
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001084300
—
FL
05
—
257737201
—
FL
Enumeration date
09/28/2006
Last updated
06/13/2013
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