Individual
JANIER DAVID CUSTODIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8169 COND SAN VICENTE CALLE CONCORDIA, 412, PONCE, PR 00716
(787) 284-5884
Mailing address
PO BOX 7793, PONCE, PR 00732-7793
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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