Goar Blanco Blasco, DC
Individual provider Active NPI Chiropractor · San Juan, PR
NPI 1265411607 · NPPES record last updated Feb 19, 2010
Key facts
- NPI
- 1265411607
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0264 (PR)
- Practice address
- 576 Calle Cesar Gonzalez
Ste 501
San Juan, PR 00918 - Phone
- (787) 751-9147
- Fax
- (787) 753-4641
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
576 Avenida Cesar Gonzalez
Suite 501
Hato Rey, PR 00918
Phone (787) 751-9147
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120418000120 | PR | Practitioner - Chiropractic | 7416133533 |
Reassigns benefits to 2 organizations Practice locations: San Juan, PR |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0264 | PR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Network Services of Puerto Rico LLC | Chiropractor | Current |
Accepting new patients |
| Quiroplaza LLC | Chiropractor | Current |
Accepting new patients |
Locations
525 Ave Fd Roosevelt
Ofc 805
San Juan, PR 00918
Phone (787) 233-1001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0264 | PR | Yes |
Addresses
Primary practice location
576 Calle Cesar Gonzalez
Ste 501
San Juan, PR 00918
Mailing address
138 Winston Churchhill
Mail Station 655
San Juan, PR 00926-0001
Phone (787) 751-9147
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 074005 | Other | PR | BLUE CROSS BLUE SHIELD |
| CP1001 | Other | PAN AMERICAN LIFE | |
| 9260158 | Other | PR | HUMANA INS PR |
| 83203 | Other | PR | PR WORKERS COMP |
| 1388 | Other | FIRST MEDICAL | |
| 51229BL | Other | PR | BLUE CROSS BLUE SHIELD PR |
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.