Healthcare Provider Details

I. General information

NPI: 1174656847
Provider Name (Legal Business Name): HORACIO COLON ESTEVA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1448 AVE FERNANDEZ JUNCOS
SAN JUAN PR
00909-2655
US

IV. Provider business mailing address

1448 AVE FERNANDEZ JUNCOS
SAN JUAN PR
00909-2655
US

V. Phone/Fax

Practice location:
  • Phone: 787-721-7776
  • Fax: 787-721-7810
Mailing address:
  • Phone: 787-721-7776
  • Fax: 787-721-7810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. NILSA L TORRES
Title or Position: FACTURADORA
Credential:
Phone: 787-721-7776