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General NPI Number Information
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NPI Number | 1558347344
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Entity Type | Individual
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Provider Name | JUAN L COLON QUINONES MD
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 526 AVE EMERITO ESTRADA
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-3122
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Country | US
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Telephone | 939-269-6856
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Fax |
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Provider Business Mailing Address
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Address Line | 77 CALLE ARECA LAS PALMAS DE CERRO GORDO
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City | VEGA ALTA
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State | PR
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Zip | 00692-9644
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Country | US
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Telephone | 939-269-6856
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Fax |
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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 | 16227
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License Number State | PR
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