Provider Demographics
NPI:1083323471
Name:GORDILS COLON, NATHALIE LORRAINE
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:LORRAINE
Last Name:GORDILS COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION BORINQUEN VALLEY
Mailing Address - Street 2:CALLE QUINQUE 295
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-299-1876
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION BORINQUEN VALLEY
Practice Address - Street 2:CALLE QUINQUE 295
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-299-1876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program