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General NPI Number Information
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NPI Number | 1831123462
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Entity Type | Individual
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Provider Name | RAMON O BLANCO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HOSPITAL DR. I. GONZALEZ MARTINEZ CENTRO MEDICO PISO 1 OFICINA 2
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City | SAN JUAN
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State | PR
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Zip | 00919-1811
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Country | US
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Telephone | 787-763-4149
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Fax |
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Provider Business Mailing Address
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Address Line | 5349 AVE ISLA VERDE APT 1012
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City | CAROLINA
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State | PR
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Zip | 00979-5509
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Country | US
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Telephone | 787-728-5347
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 3021
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License Number State | PR
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