Provider Demographics
NPI:1013209683
Name:COLON & FERNANDEZ ACUPUNCTURE PSC
Entity Type:Organization
Organization Name:COLON & FERNANDEZ ACUPUNCTURE PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-734-8042
Mailing Address - Street 1:PO BOX 1801
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1801
Mailing Address - Country:US
Mailing Address - Phone:787-734-8042
Mailing Address - Fax:787-734-6330
Practice Address - Street 1:CALLE MARTINEZ
Practice Address - Street 2:ESQUINA BETANCES #26
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-734-8042
Practice Address - Fax:787-734-6330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9827171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty