Provider Demographics
NPI:1639434020
Name:MARTINEZ-BLANCO, MAYDELIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAYDELIN
Middle Name:
Last Name:MARTINEZ-BLANCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3540
Mailing Address - Country:US
Mailing Address - Phone:727-827-2825
Mailing Address - Fax:
Practice Address - Street 1:1799 66TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5537
Practice Address - Country:US
Practice Address - Phone:727-343-2438
Practice Address - Fax:727-381-3191
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN200871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice