Ivelisse Blasini, RPH
Individual provider Active NPI Pharmacist · Juana Diaz, PR
NPI 1003035700 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003035700
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 4289 (PR)
- Practice address
- State 149 & State 584
Plaza Juana Diaz Carr.14 Inr.Carr, 584
Juana Diaz, PR 00795 - Phone
- (787) 260-1544
- Fax
- (787) 260-1544
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4289 | PR | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4289 | PR | Yes |
Addresses
Primary practice location
State 149 & State 584
Plaza Juana Diaz Carr.14 Inr.Carr, 584
Juana Diaz, PR 00795
Mailing address
State 149 & State 584
Juana Diaz, PR 00795
Phone (787) 260-1544
Other providers in Juana Diaz, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.