Provider Demographics
NPI:1235485194
Name:COLON RENOVALES, MILAGROS C (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:C
Last Name:COLON RENOVALES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1730 PR 506 FLAMBOYANES ST
Mailing Address - Street 2:03171-61
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0000
Mailing Address - Country:US
Mailing Address - Phone:787-840-8801
Mailing Address - Fax:787-840-8798
Practice Address - Street 1:1730 PR 506 FLAMBOYANES ST
Practice Address - Street 2:03171-61
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-3171
Practice Address - Country:US
Practice Address - Phone:787-840-8801
Practice Address - Fax:787-840-8798
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist