MEDICARE: DR. YIRAIMA E. MEDINA-BLASINI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	18422	PR
2	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	ME124326	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083870976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YIRAIMA E. MEDINA-BLASINI M.D.

Provider Business Mailing Address
First Line	:	AVENIDA TITO CASTRO #917
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00733-6810
Country	:	US
Telephone Number	:	787-844-2080
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVENIDA TITO CASTRO #917
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00733-6810
Country	:	US
Telephone Number	:	787-844-2080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2008
Last Update Date	:	10/03/2015

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