Provider Demographics
NPI:1508141458
Name:COLON, MARITZA (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:MARITZA
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE FRANCISCO FRANQUIE #80 URB. VALENCIA #2
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0000
Mailing Address - Country:US
Mailing Address - Phone:787-363-9173
Mailing Address - Fax:
Practice Address - Street 1:AVE. BOULEVARD DEL RIO RAMAL #3
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-0000
Practice Address - Country:US
Practice Address - Phone:787-363-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1640183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1640OtherPHARMACY TECHNICIAN