# ON SITE PREVENTIVE MEDICINE CSP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** ON SITE PREVENTIVE MEDICINE CSP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912591041
- **Authorized official:** DR. MAXIMO C BLONDET MD (OWNER)
- **Authorized official phone:** (787) 409-5869

## Contact information

- **Practice address:** 400 AVE FD ROOSEVELT STE 409, SAN JUAN, PR 00918-2163
- **Practice address phone:** (787) 903-6100
- **Practice address fax:** (787) 273-0935
- **Mailing address:** 400 AVE FD ROOSEVELT STE 409, SAN JUAN, PR 00918-2163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QP0905X | State or Local Public Health Clinic/Center | — | NULL | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QP2400X | Prison Health Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | — |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | — |
| 333300000X | Emergency Response System Companies | — | NULL | — |

## Other

- **Enumeration date:** 03/01/2021
- **Last updated:** 03/23/2021