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General NPI Number Information
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NPI Number | 1841073210
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Entity Type | Individual
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Provider Name | JEAN CARLOS SANTIAGO COLON
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Gender | Male
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Dates
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Enumeration Date | 08/17/2023
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | HOSPITAL PSIQUIATRIA FORENSES AVE. TITO CASTRO #931
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City | PONCE
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State | PR
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Zip | 00716-4717
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Country | US
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Telephone | 787-844-0210
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE MIGUEL GONZALEZ 3980 NUEVA VIDA, EL TUQUE
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City | PONCE
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State | PR
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Zip | 00728
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Country | US
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Telephone | 787-901-5826
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 16411
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License Number State | PR
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