Provider Demographics
NPI:1447212394
Name:VALENTIN BLASINI, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:VALENTIN BLASINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19297
Mailing Address - Street 2:#1507 AVE PONCE DE LEON STE C PDA 22
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00910
Mailing Address - Country:US
Mailing Address - Phone:787-725-3555
Mailing Address - Fax:787-723-6866
Practice Address - Street 1:METRO MEDICAL CENTER TORRE B SUITE 301
Practice Address - Street 2:MARGINAL URB. HNAS DAVILA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-269-3191
Practice Address - Fax:787-269-3185
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14083207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H78519Medicare UPIN
0021366Medicare ID - Type Unspecified