Provider Demographics
NPI:1659545333
Name:DIAZ-COLON, ADA Y
Entity Type:Individual
Prefix:
First Name:ADA
Middle Name:Y
Last Name:DIAZ-COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE LAGUNA APT 313
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6434
Mailing Address - Country:US
Mailing Address - Phone:787-253-0283
Mailing Address - Fax:
Practice Address - Street 1:AVE LAGUNA APT 313
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-6434
Practice Address - Country:US
Practice Address - Phone:787-253-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist