Individual provider Active NPI

Adolfo F Blanco, MD

  • General Practice Physician
  • Miami, FL
National Provider Identifier
1548355217
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME67714 Issued in FL
Practice address
11255 SW 211TH St
Miami, FL 33189-2240
Phone
(305) 278-0200
Fax
(786) 235-0145
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME67714 FL Primary

Addresses

Primary practice location

11255 SW 211TH St
Miami, FL 33189-2240

Mailing address

11255Sw211Th St
Miami, FL 33189-2240
Phone (305) 278-0200

Other identifiers 2

IdentifierTypeStateIssuer
377319100MedicaidFL
04362877OtherFLECFMG

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
I20180424002798 FL Practitioner - General Practice 8325352552 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME67714FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Care of South Florida, Inc. General Practice CurrentSince Jun 11, 2019 Accepting new patients

Locations

12171 SW 268th St
Homestead, FL 33032
Phone 30527802001020

11255 SW 211th St
Miami, FL 33189
Phone (305) 254-7576

Organizations & group practices 2

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1548355217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11255SW211TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331892240",
            "telephone_number": "305-278-0200",
            "fax_number": "305-851-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11255 SW 211TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331892240",
            "telephone_number": "305-278-0200",
            "fax_number": "786-235-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "ADOLFO",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME67714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377319100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "04362877",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.