Provider Demographics
NPI:1801775283
Name:BLABLAO LLC
Entity type:Organization
Organization Name:BLABLAO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WISARYS
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLINA VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-464-8082
Mailing Address - Street 1:RR 2 BOX 4635
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-9676
Mailing Address - Country:US
Mailing Address - Phone:787-464-8082
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 164 KM 16.2
Practice Address - Street 2:BO PALMAREJO EXTENSION MARIA DEL CARMEN
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-464-8082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty