Provider Demographics
NPI:1053116533
Name:PINO BLANCO, FARIANY DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:FARIANY
Middle Name:DE LA CARIDAD
Last Name:PINO BLANCO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9761 NW 126TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7408
Mailing Address - Country:US
Mailing Address - Phone:786-468-0471
Mailing Address - Fax:
Practice Address - Street 1:9761 NW 126TH TER
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-7408
Practice Address - Country:US
Practice Address - Phone:786-468-0471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11035445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily