Blanco, Suzette Nicole

Blanco, Suzette Nicole is an sole proprietor health care provider with primary practice located at 2685 Executive Park Dr Ste 4 , Weston FL 33331-3651. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Blanco, Suzette Nicole can be contacted via phone (954) 515-0892.

Contact Information

Primary practice address
2685 Executive Park Dr Ste 4 Weston FL 33331-3651
Phone: (954) 515-0892
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT29979 Florida

Profile Details

NPI number 1043608193
LBN Legal business name Blanco, Suzette Nicole
Credentials DPT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 23rd, 2014
Last updated Aug 22nd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043608193 NPPES
Florida MEDICAID 014078000

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