Basic Information
| Provider Information | |||||||||
| NPI: | 1841941374 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A3E | ||||||||
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| Mailing Information | |||||||||
| Address1: | HC 2 BOX 12127 | ||||||||
| Address2: | |||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006768261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876043113 | ||||||||
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| Practice Location | |||||||||
| Address1: | CARR 111 KM 11.5 BO CAPA | ||||||||
| Address2: | PLAZA QUINTANA | ||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872328561 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2022 | ||||||||
| LastUpdateDate: | 01/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | COLON BOSQUES | ||||||||
| AuthorizedOfficialFirstName: | AMNERIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PEDIATRICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7876043113 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 01/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.