Provider Demographics
NPI:1376315887
Name:COLON, DEIBELIS (DPT)
Entity Type:Individual
Prefix:
First Name:DEIBELIS
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1157
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-1157
Mailing Address - Country:US
Mailing Address - Phone:787-407-8505
Mailing Address - Fax:
Practice Address - Street 1:EURIPIDES RUBIO DEPARTMENT OF VETERANS AFFAIRS
Practice Address - Street 2:OUTPATIENT CLINIC 1802 NAVARRA STREET
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1456225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist