MEDICARE: YAMILERIS COLON-BOU MD

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	208000000X	Pediatrics Physician	24489	PR

General Provider Information

NPI Number	:	1154009025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMILERIS COLON-BOU MD

Provider Business Mailing Address
First Line	:	AVE LAGUNA GARDENS 2
Second Line	:	APT 7E
City	:	CAROLINA
State	:	PR
Zip	:	00979
Country	:	US
Telephone Number	:	910-835-7527
Fax Number	:

Provider Business Practice Location Address
First Line	:	SAN JUAN CITY HOSPITAL
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-480-2700
Fax Number	:

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	06/01/2026

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