Provider Demographics
NPI:1376201608
Name:COLON ORTIZ, MILAGROS (PH D)
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:
Last Name:COLON ORTIZ
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E22 CAMINO DE BEGONIAS
Mailing Address - Street 2:URB. ENRAMADA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-604-7435
Mailing Address - Fax:
Practice Address - Street 1:E22 CAMINO DE BEGONIAS
Practice Address - Street 2:URB. ENRAMADA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-604-7435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4787103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling