Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11076152 | FL |
NPI | 1184998890 |
---|---|
Provider Name | Andrea J Blanco |
First Address | Hialeah, FL 33015-3851 |
Second Address | Hialeah, FL 33015-3851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2012 |
Last Update Date | 27/02/2012 |