Provider Demographics
NPI:1346641438
Name:CALDERA COLON, JONATHAN
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:CALDERA COLON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LAUREL AVE., SANTA JUANITA
Mailing Address - Street 2:RAMON RUIZ ARNAU UNIVERSITY HOSPITAL
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-787-5151
Mailing Address - Fax:787-269-0050
Practice Address - Street 1:100 LAUREL AVE., SANTA JUANITA
Practice Address - Street 2:RAMON RUIZ ARNAU UNIVERSITY HOSPITAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-787-5151
Practice Address - Fax:787-269-0050
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21229207R00000X
PR31,568-R390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program