Individual
DR. PATRICIA J BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-8181
(727) 767-8030
Mailing address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-8181
(727) 767-8030
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME56974
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055154600
—
FL
01
—
0867656
AETNA
FL
01
—
12994
BLUE CROSS/BLUE SHIELD
FL
01
—
197487
WELLCARE
FL
01
—
4223375
AETNA PPO
FL
Enumeration date
08/21/2006
Last updated
11/28/2016
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