Provider Demographics
NPI:1033823430
Name:BLANDON, NATALIA A (FNP, RN)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:A
Last Name:BLANDON
Suffix:
Gender:F
Credentials:FNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 SW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-2505
Mailing Address - Country:US
Mailing Address - Phone:954-628-6483
Mailing Address - Fax:
Practice Address - Street 1:7020 SW 82ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-2505
Practice Address - Country:US
Practice Address - Phone:954-628-6483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9583885163W00000X
FL11036780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse