Provider Demographics
NPI:1295548352
Name:BLANC, SUVENES
Entity type:Individual
Prefix:
First Name:SUVENES
Middle Name:
Last Name:BLANC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 NE 141ST ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-3128
Mailing Address - Country:US
Mailing Address - Phone:941-465-3163
Mailing Address - Fax:
Practice Address - Street 1:531 NE 141ST ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-3128
Practice Address - Country:US
Practice Address - Phone:941-465-3163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9537148163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse