MEDICARE: DAVID E BLAS-BORIA 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	2084N0400X	Neurology Physician	17216	PR

General Provider Information

NPI Number	:	1366642332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID E BLAS-BORIA M.D.

Provider Business Mailing Address
First Line	:	RR 36 BOX 1362
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-9704
Country	:	US
Telephone Number	:	787-479-6889
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 CALLE PADIAL GATSBY PLAZA
Second Line	:	SUITE 318
City	:	CAGUAS
State	:	PR
Zip	:	00725-3807
Country	:	US
Telephone Number	:	787-479-6889
Fax Number	:

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

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	02/11/2015

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