Individual
FEDELINE BLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4249 NW 61ST CT, COCONUT CREEK, FL 33073-3277
(786) 985-1898
Mailing address
4249 NW 61ST CT, COCONUT CREEK, FL 33073-3277
(786) 985-1898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
001324-P.A
PR
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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