Provider Demographics
NPI:1144180498
Name:BLUESPAN HEALTH LLC
Entity type:Organization
Organization Name:BLUESPAN HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:AILEEN
Authorized Official - Last Name:SORIANO-PISATURO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-361-0405
Mailing Address - Street 1:1525 WAMPANOAG TRL STE 202
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1038
Mailing Address - Country:US
Mailing Address - Phone:401-203-3636
Mailing Address - Fax:401-203-3828
Practice Address - Street 1:1525 WAMPANOAG TRL STE 202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-1038
Practice Address - Country:US
Practice Address - Phone:401-203-3636
Practice Address - Fax:401-203-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty