Individual
JOSE BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 RICHMOND SQ STE 110, PROVIDENCE, RI 02906-5135
(401) 414-1400
(401) 414-1401
Mailing address
2 RICHMOND SQ STE 110, PROVIDENCE, RI 02906-5135
(401) 414-1400
(401) 414-1401
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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