Individual
EILEEN AMARILYS BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 MABBETTE ST, KISSIMMEE, FL 34741-5161
(407) 201-8079
Mailing address
982 VINELAND PL, LAKE MARY, FL 32746-1824
(407) 925-4498
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT22273
FL
Other
Enumeration date
09/20/2021
Last updated
05/30/2023
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