Healthcare Provider Details

I. General information

NPI: 1043125438
Provider Name (Legal Business Name): JOSNER BUITRAGO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 VALLE DE TORRIMAR APT A306
GUAYNABO PR
00966-8700
US

IV. Provider business mailing address

126 VALLES DE TORRIMAR APT A306
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 929-346-1620
  • Fax:
Mailing address:
  • Phone: 929-346-1620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: