Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 18345 | PR |
NPI | 1023322625 |
---|---|
Provider Name | Dr. Jaime Enrique Colon Casasnovas |
First Address | San Juan, PR 00919-0990 |
Second Address | Carolina, PR 00987-8797 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2010 |
Last Update Date | 16/04/2020 |