Provider Demographics
NPI:1548237712
Name:COLON, CANDIDA (LND)
Entity Type:Individual
Prefix:
First Name:CANDIDA
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND BONNEVILLE
Mailing Address - Street 2:7 GUAYNABO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-5606
Mailing Address - Country:US
Mailing Address - Phone:787-744-2516
Mailing Address - Fax:
Practice Address - Street 1:URB BAIROA
Practice Address - Street 2:BS4 LAS AMERICAS AVE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0000
Practice Address - Country:US
Practice Address - Phone:787-746-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR805133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered