NPIMap

Organization Active NPI

Dr. Jessica Blanco OD PA

  • Optometrist
  • Miami, FL
National Provider Identifier
1528442373
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4746 Issued in FL
Legal business name
DR. JESSICA BLANCO OD PA
Practice address
9646 SW 24TH St
Miami, FL 33165-8015
Phone
(305) 846-9158
NPI assigned
Jul 10, 2015
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Dr. Jessica Blanco, ODNPI 1942559083
Title
President
Phone
(305) 582-2598

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 4746 FL Primary

Addresses

Primary practice location

9646 SW 24TH St
Miami, FL 33165-8015

Mailing address

8952 Grand Canal Dr
Miami, FL 33174-2305
Phone (305) 582-2598

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1528442373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8952 GRAND CANAL DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331742305",
            "telephone_number": "305-582-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9646 SW 24TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331658015",
            "telephone_number": "305-846-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JESSICA BLANCO OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "BLANCO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-582-2598",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.