Provider Demographics
NPI:1821747056
Name:BIBILONI, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:BIBILONI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 CALLE LAUREL CONDOMINIO PARK BOULEVARD
Mailing Address - Street 2:APARTEMENTO 912
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00913
Mailing Address - Country:US
Mailing Address - Phone:787-245-9497
Mailing Address - Fax:
Practice Address - Street 1:2305 CALLE LAUREL CONDOMINIO PARK BOULEVARD
Practice Address - Street 2:APARTEMENTO 912
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00913
Practice Address - Country:US
Practice Address - Phone:787-245-9497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program