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General NPI Number Information
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NPI Number | 1962594366
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Entity Type | Individual
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Provider Name | JOSE ANTONIO COLON VILLAFANE M:D:
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | STREET 438 KM0.1 DOMINGO RUIZ HC-01 B0X 4829
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City | SABANA HOYOS
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State | PR
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Zip | 00688-9714
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Country | US
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Telephone | 787-881-9271
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Fax | 787-881-9271
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Provider Business Mailing Address
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Address Line | STREET 438 KM0.1 DOMINGO RUIZ HC-01 B0X 4829
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City | SABANA HOYOS
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State | PR
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Zip | 00688-9714
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Country | US
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Telephone | 787-881-9271
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Fax | 787-881-9271
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 12039
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License Number State | PR
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