Vivian Blanco Lezcano

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16426 Issued in FL

Practice address

12150 SW 128TH CT Ste 228
Miami, FL 33186-4674

Phone

(786) 712-7151

NPI assigned

Jun 22, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Southern Rehabilitation Group LLC

  • Developmental Disabilities Clinic/Center
  • Miami Lakes, FL
  • NPI 1104489079
  NPD Authorized official
• Callisia Health Group Inc

  • Psychiatry Physician
  • Miami, FL
  • NPI 1528685187
  NPD

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1225489180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9260 SW 149TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331961675",
            "telephone_number": "786-319-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 SW 128TH CT STE 228",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331864674",
            "telephone_number": "786-712-7151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9260 SW 149th Ct",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331961675",
            "country_code": "US",
            "telephone_number": "786-319-0748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "654 NE 9th Pl",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330304934",
            "country_code": "US",
            "telephone_number": "305-248-3488",
            "fax_number": "305-248-6558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 NW 107th Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Sweetwater",
            "state": "FL",
            "postal_code": "331722746",
            "country_code": "US",
            "telephone_number": "786-542-5043",
            "fax_number": "786-542-5049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO LEZCANO",
        "first_name": "VIVIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16426",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101362100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "MH16426",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Miami",
            "affiliation": "N",
            "address_1": "1400 NW 107th Ave Ste 310",
            "city": "Sweetwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331722746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Miami",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1400 NW 107th Ave Ste 310",
            "city": "Sweetwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331722746",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Miami",
            "affiliation": "N",
            "address_1": "12150 SW 128th Ct Ste 228",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331864674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lourdes Blanco Gonzalez
• Victor Manuel Blanco Gonzalez, RBT
• Jesica Blanco Hernandez
• Blanco Home Health Care Corporation
• Blanco Jamis Dental Group, P.a.
• Yumay Blanco Llanes
• Adrian Emelio Blanco Lopez, RBT
• Zuzel Blanco Lopez
• Yanela Blanco Martinez, APRN
• Blanco Medical Center LLC

• Mental Health Counselor in Miami, FL
• Providers in Miami, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.