MEDICARE: DR. JOSE L. COLON-DUENO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	7249	PR
2	208100000X	Physical Medicine & Rehabilitation Physician	7249	PR

General Provider Information

NPI Number	:	1023159027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE L. COLON-DUENO M.D.

Provider Business Mailing Address
First Line	:	PO BOX 195004
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00919-5004
Country	:	US
Telephone Number	:	787-748-1726
Fax Number	:	787-748-1726

Provider Business Practice Location Address
First Line	:	12 CALLE HERADIO MENDOZA E
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00736-3801
Country	:	US
Telephone Number	:	787-263-6464
Fax Number	:	787-263-6466

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2007
Last Update Date	:	07/30/2015

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Directions to “ DR. JOSE L. COLON-DUENO M.D.” Practice Location

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