Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 7249 | PR |
NPI | 1023159027 |
---|---|
Provider Name | Dr. Jose L. Colon-Dueno |
First Address | San Juan, PR 00919-5004 |
Second Address | Cayey, PR 00736-3801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2007 |
Last Update Date | 30/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E-30743 | (02) | PR |