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General NPI Number Information
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NPI Number | 1598763658
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Entity Type | Organization
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Legal Business Name | FRONTERA COLON & SUAREZ - RADIOLOGOS PSC
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Dates
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Enumeration Date | 07/12/2005
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 1065 AVE LOS CORAZONES EDIF MEDICO PROFESIONAL; OFIC 110-111
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City | MAYAGUEZ
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State | PR
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Zip | 00680-7060
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Country | US
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Telephone | 787-831-5922
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Fax | 787-831-5922
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Provider Business Mailing Address
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Address Line | PO BOX 6470
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City | MAYAGUEZ
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State | PR
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Zip | 00681-6470
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Country | US
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Telephone | 787-265-3730
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Fax | 787-265-3730
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANGEL R COLON LOYOLA
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Credential | M.D.
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Telephone | 787-314-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 10300
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License Number State | PR
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