Provider Demographics
NPI:1023012630
Name:HERNANDEZ COLON, ANGEL WILFREDO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:WILFREDO
Last Name:HERNANDEZ 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:INSTITUTO SAN PABLO
Mailing Address - Street 2:#66 SANTA CRUZ ST . STE 501
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7050
Mailing Address - Country:US
Mailing Address - Phone:787-787-1085
Mailing Address - Fax:787-785-2469
Practice Address - Street 1:INSTITUTO SAN PABLO
Practice Address - Street 2:#66 SANTA CRUZ ST. STE 501
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7041
Practice Address - Country:US
Practice Address - Phone:787-787-1085
Practice Address - Fax:787-785-2469
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3248174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist