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Individual

JULIO MIGUEL BLASCO JIMENEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 649-4050
(401) 649-4051
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD18198
RI
390200000X
Student in an Organized Health Care Education/Training Program
4351044570
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1659933778
RI
Enumeration date
06/28/2019
Last updated
03/04/2026
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