Provider Demographics
NPI:1538323134
Name:BIANCO, COLLEEN (ARNP)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:BIANCO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 SW 131ST AVE
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4731
Mailing Address - Country:US
Mailing Address - Phone:954-873-7228
Mailing Address - Fax:
Practice Address - Street 1:2964 N STATE ROAD 7
Practice Address - Street 2:SUITE 320
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5715
Practice Address - Country:US
Practice Address - Phone:954-796-0111
Practice Address - Fax:954-796-0120
Is Sole Proprietor?:No
Enumeration Date:2008-07-12
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9232779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily