Provider Demographics
NPI:1457858995
Name:BLANCO FERNANDEZ, ANAMARYS (MD)
Entity Type:Individual
Prefix:
First Name:ANAMARYS
Middle Name:
Last Name:BLANCO FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W 8TH ST FL CENTER5
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:904-244-3932
Mailing Address - Fax:904-244-3629
Practice Address - Street 1:655 W 8TH ST FL CENTER5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-3932
Practice Address - Fax:904-244-3629
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program