Provider Demographics
NPI:1609122589
Name:COLON PEREZ, KARLA N (LND, RD)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:N
Last Name:COLON PEREZ
Suffix:
Gender:F
Credentials:LND, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 CALLE GRUS
Mailing Address - Street 2:URB PARQUE DE ISLA VERDE
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-1384
Mailing Address - Country:US
Mailing Address - Phone:787-371-0507
Mailing Address - Fax:
Practice Address - Street 1:155 CALLE DEL PARQUE
Practice Address - Street 2:CASTILLO DEL PARQUE APT 1D
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1987
Practice Address - Country:US
Practice Address - Phone:787-371-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1595133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered