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MARIO BLANCO MD

Anatomic Pathology & Clinical Pathology >> Pathology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1891754917

Individual Registrant:
 MARIO  BLANCO MD
Gender: M
Sole Proprietor

Location and contact information for practice:
2100 PREVATT ST  EUSTIS, FL 32726-6130 US
Tel: 352-308-8903  Fax: 352-460-0785

Contact information for business:
2815 GREENBRIAR BLVD  WELLINGTON, FL 33414-7157 US
Tel: 561-204-5455  Fax: 561-204-5455

Registration Information:
NPI: 1891754917
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207ZP0102XAllopathic & Osteopathic Physicians
Pathology
Anatomic Pathology & Clinical Pathology
FL90265

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
GROUP NPI1265798870FL01
269882000FL05




HEALTH CARE JOBS FL - Page 1



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