Provider Demographics
NPI:1467773317
Name:COLON MARTINEZ, GLORIA LYMARI (MD)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:LYMARI
Last Name:COLON MARTINEZ
Suffix:
Gender:F
Credentials:MD
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 370129
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-0129
Mailing Address - Country:US
Mailing Address - Phone:787-391-4835
Mailing Address - Fax:
Practice Address - Street 1:5 AVE JOSE DE DIEGO E
Practice Address - Street 2:SUITE #2
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-3818
Practice Address - Country:US
Practice Address - Phone:787-535-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18022208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice