Provider Demographics
NPI:1467060806
Name:RODRIGUEZ COLON, CAROLINA HILDA (DDS)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:HILDA
Last Name:RODRIGUEZ COLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15723 IBISRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-3895
Mailing Address - Country:US
Mailing Address - Phone:813-789-8055
Mailing Address - Fax:
Practice Address - Street 1:3848 SUN CITY CENTER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33573-6843
Practice Address - Country:US
Practice Address - Phone:813-633-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25109122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist