Individual provider Active NPI

Javier Diaz Blanco, MD

  • Neonatal-Perinatal Medicine Physician
  • Cocoa Beach, FL
National Provider Identifier
1093741670
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
ME42915 Issued in FL
Practice address
701 W Cocoa Beach Cswy
Center for Neonatal Care
Cocoa Beach, FL 32931-3585
Phone
(407) 303-2528
Fax
(407) 303-2509
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X ME42915 FL Primary

Addresses

Primary practice location

701 W Cocoa Beach Cswy
Center for Neonatal Care
Cocoa Beach, FL 32931-3585

Mailing address

2501 N Orange Ave Ste 446
Orlando, FL 32804-4644
Phone (407) 303-2528

Other identifiers 1

IdentifierTypeStateIssuer
042038700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150615002453 FL Practitioner - Pediatric Medicine 2961722988 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Apr 20, 2015 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 28, 2016 Accepting new patients
The Nemours Foundation CurrentSince Apr 20, 2015 Accepting new patients
The Nemours Foundation Current Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 28, 2016 Accepting new patients

Locations

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931
Phone (321) 799-7111

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 446
Orlando, FL 32804
Phone (407) 975-0412

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1093741670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 446",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644",
            "telephone_number": "407-303-2528",
            "fax_number": "407-303-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W COCOA BEACH CSWY",
            "address_2": "CENTER FOR NEONATAL CARE",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313585",
            "telephone_number": "407-303-2528",
            "fax_number": "407-303-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAZ BLANCO",
        "first_name": "JAVIER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME42915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042038700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

Verify at the official NPI Registry.