Individual
DAILY PINO BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
CARRETERA #2 KM, VEGA BAJA, VEGA BAJA, PR 00693
(787) 858-1580
Mailing address
728 AVE ESCORIAL, SAN JUAN, PR 00920-4731
(786) 757-7809
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
24609
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24609
STATAL LICENSE
PR
Enumeration date
07/11/2024
Last updated
11/06/2025
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