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General NPI Number Information
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NPI Number | 1851593057
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Entity Type | Individual
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Provider Name | JORGE L SURIA-COLON MD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | C1 CALLE NOGAL CAPARRA HILLS
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City | GUAYNABO
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State | PR
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Zip | 00968-3106
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Country | US
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Telephone | 787-787-4640
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Fax |
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Provider Business Mailing Address
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Address Line | C1 CALLE NOGAL CAPARRA HILLS
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City | GUAYNABO
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State | PR
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Zip | 00968-3106
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Country | US
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Telephone | 787-787-4640
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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 | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | 4013
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License Number State | PR
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