Deandra Dion Blanco

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

110337825 Issued in FL

Practice address

10710 Grande Palladium Way
Boynton Beach, FL 33436-5063

Phone

(786) 238-6703

NPI assigned

May 2, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1104615558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 GRANDE PALLADIUM WAY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334365063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 GRANDE PALLADIUM WAY",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334365063",
            "telephone_number": "786-238-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "DEANDRA",
        "middle_name": "DION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "110337825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bita Khoshrou DMD of Boynton PA
• BJ'S Wholesale Club Inc.
• Amoi Kyann Black, CBHCM
• Arianna Black
• Max V Black, MD
• Diana Dion Blanco
• Ilia M. Blandina, CNM
• Howard Steven Blank, M.D.
• Dana Blasko, P.A.
• Dana Hailey Blocker, APRN

• All providers in Boynton Beach, FL
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.