Organization
ON SITE PREVENTIVE MEDICINE CSP
Active
Other names
ON SITE PREVENTIVE MEDICINE CSP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAXIMO C BLONDET MD (OWNER)
(787) 409-5869
Entity
Organization
Contact information
Practice address
400 AVE FD ROOSEVELT STE 409, SAN JUAN, PR 00918-2163
(787) 903-6100
(787) 273-0935
Mailing address
400 AVE FD ROOSEVELT STE 409, SAN JUAN, PR 00918-2163
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QP2400X
Prison Health Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
333300000X
Emergency Response System Companies
—
—
Other
Enumeration date
03/01/2021
Last updated
03/23/2021
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