Blancas, Gustavo Dario

Blancas, Gustavo Dario is an individual health care provider with primary practice located at 1350 Hickory St , Melbourne FL 32901. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Blancas, Gustavo Dario can be contacted via phone (321) 434-1771.

Contact Information

Primary practice address
1350 Hickory St Melbourne FL 32901
Phone: (321) 434-1771
Fax: (321) 434-1775
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X APRN9268820 Florida

Profile Details

NPI number 1184054959
LBN Legal business name Blancas, Gustavo Dario
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2013
Last updated Apr 8th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184054959 NPPES
Florida MEDICAID 011063000
Florida Other HU281Y

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