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General NPI Number Information
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NPI Number | 1518049766
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Entity Type | Individual
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Provider Name | JOSE M CANABAL ENRIQUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | CENTRO COMERCIAL BARINAS CARRETERA 335 KM.1.5 BARIO BARINAS
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City | YAUCO
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State | PR
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Zip | 00698-0000
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Country | US
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Telephone | 787-645-3658
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Fax | 787-856-4966
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Provider Business Mailing Address
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Address Line | URB. EL ROSARIO CALLE 3 #20
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City | YAUCO
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State | PR
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Zip | 00698-0000
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Country | US
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Telephone | 787-645-3658
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Fax | 787-856-4966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 12249
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License Number State | PR
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