Individual provider Active NPI

Luis Manuel Blanco, ARNP-C

  • Family Nurse Practitioner
  • Ft Lauderdale, FL
National Provider Identifier
1790134641
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9404464 Issued in FL
Practice address
1995 E Oakland Park Blvd Ste 250
Ft Lauderdale, FL 33306-1149
Phone
(615) 657-4805
Fax
(954) 337-2733
NPI assigned
Jun 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9404464 FL Primary

Addresses

Primary practice location

1995 E Oakland Park Blvd Ste 250
Ft Lauderdale, FL 33306-1149

Mailing address

1995 E Oakland Park Blvd Ste 250
Ft Lauderdale, FL 33306-1149
Phone (615) 657-4805

Other practice location 1

2979 SW 134th Ave
Miramar, FL 33027-3915
Phone (305) 720-9730

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
I20170211000133 FL Practitioner - Nurse Practitioner 2365725652 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Practitioners, LLCGroup PAC ID 1658688304, 63 clinicians

Practice addresses (Care Compare)

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149
Phone (954) 229-8635

703 N Flamingo Rd
Memorial Hospital West
Pembroke Pines, FL 33028-1006
Phone (954) 436-5000

8201 W Broward Blvd
Plantation, FL 33324-2701
Phone (954) 473-6600

PO Box
Suite 277854
Miramar, FL 33027-7854

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • HCA Florida University Hospital Hospital, Davie, FL, CCN 100360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9404464FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luis Manuel Blanco FNP-C LLC CurrentSince Nov 20, 2018 Accepting new patients
Ap of Nashville, LLC PastSince Nov 16, 2016 Accepting new patients
Florida Practitioners, LLC PastSince Jun 28, 2020 Accepting new patients

Locations

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1790134641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD STE 250",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061149",
            "telephone_number": "615-657-4805",
            "fax_number": "954-337-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E OAKLAND PARK BLVD STE 250",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061149",
            "telephone_number": "615-657-4805",
            "fax_number": "954-337-2733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2979 SW 134th Ave",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330273915",
            "country_code": "US",
            "telephone_number": "305-720-9730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "LUIS",
        "middle_name": "MANUEL",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-10",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9404464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.