Provider Demographics
NPI:1871292292
Name:BLOG MEDICAL LLC
Entity type:Organization
Organization Name:BLOG MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NORBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-404-0075
Mailing Address - Street 1:PO BOX 1625
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-3625
Mailing Address - Country:US
Mailing Address - Phone:787-404-0075
Mailing Address - Fax:
Practice Address - Street 1:313 CARR 869 # KM 1/5
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-7075
Practice Address - Country:US
Practice Address - Phone:787-404-0075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier