Provider Demographics
NPI:1295188191
Name:COLON GARCIA-MOLINER, CLARA M (MD)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:M
Last Name:COLON GARCIA-MOLINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:MARIA
Other - Last Name:COLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 76
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-3545
Mailing Address - Fax:
Practice Address - Street 1:1 CALLE JOSE CANDELAS STE 209
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-1423
Practice Address - Country:US
Practice Address - Phone:787-854-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301506389207W00000X
PR23114207W00000X, 207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301506389OtherBOARD OF MEDICINE, MICHIGAN
PR23114OtherPR MEDICAL LICENSE AND DISCIPLINE BOARD
MI4351044153OtherLICENSE
PR23114OtherPR MEDICAL LICENSE AND DISCIPLINE BOARD