Provider Demographics
NPI:1679559462
Name:COLON, MELBA IRIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MELBA
Middle Name:IRIS
Last Name:COLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0279
Mailing Address - Country:US
Mailing Address - Phone:787-379-5055
Mailing Address - Fax:787-305-7455
Practice Address - Street 1:HOSPITAL HERMANOS MELENDEZ
Practice Address - Street 2:CARR. # 2 KM 11.7
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-785-3398
Practice Address - Fax:787-288-1593
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR6821207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR99295Medicare ID - Type UnspecifiedPROVIDER NUMBER