Provider Demographics
NPI:1679596670
Name:CELESTE RODRIGUEZ COLON, M.D., P.S.C.
Entity Type:Organization
Organization Name:CELESTE RODRIGUEZ COLON, M.D., P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-313-0237
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:787-714-2288
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:00739-0000
Practice Address - Country:US
Practice Address - Phone:787-714-2288
Practice Address - Fax:787-739-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16423261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-66015Medicare UPIN