Provider Demographics
NPI:1508249483
Name:RUBEN COLON
Entity Type:Organization
Organization Name:RUBEN COLON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-385-4094
Mailing Address - Street 1:PO BOX 8025
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-8025
Mailing Address - Country:US
Mailing Address - Phone:787-385-4094
Mailing Address - Fax:787-620-6571
Practice Address - Street 1:200 AVE WINSTON CHURCHILL
Practice Address - Street 2:SUITE 402
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6651
Practice Address - Country:US
Practice Address - Phone:787-385-4094
Practice Address - Fax:787-766-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty