MARLON BLANCO – Adult Health Nurse Practitioner, NPI 1093068090

MARLON BLANCO is a healthcare provider. based in Miami, Florida. specializing in NURSE PRACTITIONER. They hold a License No. 9250137 (FL). The NPI Number for MARLON BLANCO is 1093068090

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
MARLON BLANCO
NPI
1093068090
Phone
(305) 282-4063
Address
900 SW 104TH CT
Enumeration Date
16 October 2012
Last Update Date
10 February 2026

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
8552266633
Graduation Year
2012 (14 years ago)
PAC ID
2769604008
Group Practice PAC ID
1759565047
Professional Enrollment ID
I20141121000710
Address ID
FL330244062HO6517XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness85
Years active:13State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for MARLON BLANCO

  • 900 SW 104TH CT

    B103

    MIAMI, FL 331742660

    Phone: (305) 282-4063

    Type: Location

  • 6517 TAFT ST

    HOLLYWOOD, FL 330244062

    Phone: (305) 282-4063

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-11-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141121000710INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33174)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759565047View full group profile
NameSpecialtyState
General PracticeFL
-FL
Nurse PractitionerFL
-FL
-FL
Family PracticeFL
-FL
Cardiovascular Disease (Cardiology), Internal MedicineFL
Internal MedicineOH
Physician AssistantFL

Reviews

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Frequently asked questions

Is MARLON BLANCO listed with a National Provider Identifier?
Yes — MARLON BLANCO has NPI 1093068090 on file in the registry.
Is MARLON BLANCO still an active registrant?
MARLON BLANCO carries an active NPI according to the public dataset.
How would a patient describe MARLON BLANCO's focus?
For MARLON BLANCO, the primary taxonomy reads as Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is MARLON BLANCO associated with Miami?
Public fields place MARLON BLANCO around Miami, Florida. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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