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General NPI Number Information
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NPI Number | 1134231327
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Entity Type | Individual
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Provider Name | CARLA MARIA BLANCO MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10 CALLE CASIA
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City | SAN JUAN
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State | PR
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Zip | 00921-3200
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Country | US
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Telephone | 787-758-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 656 CALLE ESTADO APT.6B
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City | SAN JUAN
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State | PR
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Zip | 00907-3524
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Country | US
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Telephone | 787-725-8943
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 14744
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License Number State | PR
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