Individual provider Active NPI

Geramy Garcia Blanco, NPRN

  • Family Nurse Practitioner
  • Miami, FL
National Provider Identifier
1760074082
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013407 Issued in FL
Practice address
8501 SW 124TH Ave Ste 205a
Miami, FL 33183-4633
Phone
(786) 803-8851
Fax
(786) 803-8861
NPI assigned
Feb 8, 2021
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11013407 FL Primary
Behavior Technician 106S00000X FL

Addresses

Primary practice location

8501 SW 124TH Ave Ste 205a
Miami, FL 33183-4633

Mailing address

16685 SW 80TH Ter
Miami, FL 33193-5783
Phone (786) 818-1197

Other practice location 1

4445 W 16th Ave Ste 602
Hialeah, FL 33012-2960
Phone (786) 334-5663

Other practice location 2

16685 SW 80th Ter
Miami, FL 33193-5783
Phone (786) 818-1197

Other identifiers 2

IdentifierTypeStateIssuer
117158400MedicaidFL
109636700MedicaidFL

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230202002269 FL Practitioner - Nurse Practitioner 0941603799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11013407FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kendall Therapy for Kids Corp Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1760074082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16685 SW 80TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331935783",
            "telephone_number": "786-818-1197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8501 SW 124TH AVE STE 205A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331834633",
            "telephone_number": "786-803-8851",
            "fax_number": "786-803-8861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4445 W 16th Ave Ste 602",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330122960",
            "country_code": "US",
            "telephone_number": "786-334-5663",
            "fax_number": "786-431-5578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16685 SW 80th Ter",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331935783",
            "country_code": "US",
            "telephone_number": "786-818-1197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA BLANCO",
        "first_name": "GERAMY",
        "credential": "NPRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-08",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013407",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117158400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109636700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.