Provider Demographics
NPI:1528579448
Name:BLANC, VERNET (NP)
Entity Type:Individual
Prefix:MR
First Name:VERNET
Middle Name:
Last Name:BLANC
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NE 195TH ST APT 604
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3417
Mailing Address - Country:US
Mailing Address - Phone:305-206-1334
Mailing Address - Fax:
Practice Address - Street 1:800 NE 195TH ST APT 604
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-3417
Practice Address - Country:US
Practice Address - Phone:305-206-1334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9200175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily