Provider Demographics
NPI:1679341325
Name:MACEDA BLANCO, AIMEE (APRN-BC, FNP)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:MACEDA BLANCO
Suffix:
Gender:F
Credentials:APRN-BC, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16731 NW 78TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-3402
Mailing Address - Country:US
Mailing Address - Phone:786-930-0218
Mailing Address - Fax:
Practice Address - Street 1:16731 NW 78TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-3402
Practice Address - Country:US
Practice Address - Phone:786-930-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017063363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner