Active NPI
Sullymar Blanco
- Nuclear Medicine Technology Radiologic Technologist
- Caguas, PR
National Provider Identifier
1346901758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Technology Radiologic Technologist
- License
- 000149
- Practice address
- 441 Calle Tarragona
Caguas, PR 00727-1421 - Phone
- (787) 378-0095
- NPI assigned
- Jan 7, 2022
- Last updated
- Jan 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Technology Radiologic Technologist | 2471N0900X | 000149 | PR | Primary |
Addresses
Primary practice location
441 Calle Tarragona
Caguas, PR 00727-1421
Mailing address
441 Calle Tarragona
Caguas, PR 00727-1421
Phone (787) 378-0095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000149 | PR | MD | Nuclear Medicine Technology Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1346901758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 CALLE TARRAGONA",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007271421",
"telephone_number": "787-378-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 CALLE TARRAGONA",
"city": "CAGUAS",
"state": "PR",
"postal_code": "007271421",
"telephone_number": "787-378-0095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCO",
"first_name": "SULLYMAR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-07",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "2471N0900X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Nuclear Medicine Technology",
"state": "PR",
"license": "000149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caguas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.