Healthcare Provider Details

I. General information

NPI: 1184098360
Provider Name (Legal Business Name): DR. FRANCISCO J BLANES MAYANS CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2015
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 CALLE JULIO CINTRON EDIFICIO GUAYACAN SUITE 218
AIBONITO PR
00705
US

IV. Provider business mailing address

PO BOX 1270
AIBONITO PR
00705-1270
US

V. Phone/Fax

Practice location:
  • Phone: 787-615-8780
  • Fax:
Mailing address:
  • Phone: 787-615-8780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number12873
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number12873
License Number StatePR

VIII. Authorized Official

Name: DR. FRANCISCO JOSE BLANES MAYANS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-615-8780