Provider Demographics
NPI:1629171525
Name:RODRIGUEZ COLON, CELESTE (MD)
Entity Type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:
Last Name:RODRIGUEZ COLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELESTE
Other - Middle Name:
Other - Last Name:RODRIGUEZ COLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 373471
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-3471
Mailing Address - Country:US
Mailing Address - Phone:787-313-0237
Mailing Address - Fax:787-739-5800
Practice Address - Street 1:CARR. 734 KM 0.5 BO. ARENAS
Practice Address - Street 2:CIDRA PROFESSIONAL CENTER OFIC 5
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-714-2288
Practice Address - Fax:787-739-5800
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16423208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-66015Medicare UPIN