MEDICARE: DR. JOSE RAMON COLON - LEON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	6480	PR

General Provider Information

NPI Number	:	1356346019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE RAMON COLON - LEON MD

Provider Business Mailing Address
First Line	:	PO BOX 40987
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00940-0987
Country	:	US
Telephone Number	:	787-724-7759
Fax Number	:	787-724-7766

Provider Business Practice Location Address
First Line	:	CALLE VICTORIA
Second Line	:	1559 1-B
City	:	SANTURCE
State	:	PR
Zip	:	00912
Country	:	US
Telephone Number	:	787-724-7759
Fax Number	:	787-724-7766

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/01/2016

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