Provider Demographics
NPI:1215192919
Name:BLONDET CASTELLANO, ZOET (OD)
Entity Type:Individual
Prefix:
First Name:ZOET
Middle Name:
Last Name:BLONDET CASTELLANO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ZOET
Other - Middle Name:
Other - Last Name:BLONDET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1593 CALLE TORINO
Mailing Address - Street 2:URB. FUENTEBELLA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-245-0079
Mailing Address - Fax:
Practice Address - Street 1:1593 CALLE TORINO
Practice Address - Street 2:URB. FUENTEBELLA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-245-0079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist