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General NPI Number Information
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NPI Number | 1558475137
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Entity Type | Individual
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Provider Name | JANINE S COLON GENERAL PRACTICE
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 111 CALLE JOSE C VAZQUEZ
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City | AIBONITO
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State | PR
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Zip | 00705-3301
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Country | US
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Telephone | 787-735-8787
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Fax | 787-735-8787
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Provider Business Mailing Address
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Address Line | PO BOX 441
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City | AIBONITO
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State | PR
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Zip | 00705-0441
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Country | US
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Telephone | 787-626-3684
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Fax | 787-626-3684
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 13270
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License Number State | PR
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