Provider Demographics
NPI:1356770226
Name:SUAREZ COLON, JORGE CARLOS (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:CARLOS
Last Name:SUAREZ COLON
Suffix:
Gender:M
Credentials:MD
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 APT 707
Mailing Address - Street 2:CALLE LAUREL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00913-4608
Mailing Address - Country:US
Mailing Address - Phone:787-406-5428
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL AUXILIO MUTUO
Practice Address - Street 2:AVE. PONCE DE LEON PARADA 37
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-469-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18788208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18788OtherOTHER