Blanco, Mario
Blanco, Mario is an sole proprietor health care provider with primary practice located at 2100 Prevatt St , Eustis FL 32726-6130. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Blanco, Mario can be contacted via phone (352) 308-8903.Contact Information
Primary practice address
2100 Prevatt St
Eustis FL 32726-6130
Phone: (352) 308-8903
Fax: (352) 460-0785
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 90265 | Florida |
Profile Details
| NPI number | 1891754917 |
|---|---|
| LBN Legal business name | Blanco, Mario |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 18th, 2006 |
| Last updated | Oct 3rd, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891754917 | NPPES |
| Florida | Other | 1265798870 | GROUP NPI |
| Florida | MEDICAID | 269882000 | GROUP NPI |
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