Healthcare Provider Details

I. General information

NPI: 1437379773
Provider Name (Legal Business Name): BLANCA ROBLES BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOLAR 2 REPARTO MARICAO
VEGA ALTA PR
00692
US

IV. Provider business mailing address

P. O. BOX 5294
VEGA ALTA PR
00692-5294
US

V. Phone/Fax

Practice location:
  • Phone: 787-763-7521
  • Fax: 787-763-2480
Mailing address:
  • Phone: 787-763-7521
  • Fax: 787-763-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2719
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: