NPIMap

Organization Active NPI

Jacky Blank MD PA

  • Pulmonary Disease Physician
  • Aventura, FL
National Provider Identifier
1285961227
Registry record updated Nov 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME 101336 Issued in FL
Legal business name
JACKY BLANK MD PA
Practice address
20814 W Dixie Hwy
Aventura, FL 33180-1147
Phone
(305) 933-8433
NPI assigned
Nov 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2009

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

Authorized official

Name
Dr. Jacky Bruce Blank, MDNPI 1356667430
Title
Director
Phone
(305) 933-8433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X ME 101336 FL Primary

Addresses

Primary practice location

20814 W Dixie Hwy
Aventura, FL 33180-1147

Mailing address

20814 W Dixie Hwy
Aventura, FL 33180-1147
Phone (305) 933-8433

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257984000000",
    "number": "1285961227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20814 W DIXIE HWY",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801147",
            "telephone_number": "305-933-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20814 W DIXIE HWY",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801147",
            "telephone_number": "305-933-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKY BLANK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "JACKY",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "305-933-8433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME 101336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.