Provider Demographics
NPI:1841263308
Name:LANDRON, JOSE L (RN)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:L
Last Name:LANDRON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2382
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-2382
Mailing Address - Country:US
Mailing Address - Phone:787-245-6610
Mailing Address - Fax:
Practice Address - Street 1:NAVY RESERVE CENTER PUERTO RICO
Practice Address - Street 2:218 BROOK STREET
Practice Address - City:FT. BUCHANAN
Practice Address - State:PR
Practice Address - Zip Code:00934-4206
Practice Address - Country:US
Practice Address - Phone:787-707-2332
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR026101163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice