Provider Demographics
NPI:1710247994
Name:COLON, HECTOR MANUEL (RN,BSN)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:MANUEL
Last Name:COLON
Suffix:
Gender:M
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1945
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1945
Mailing Address - Country:US
Mailing Address - Phone:787-238-8112
Mailing Address - Fax:
Practice Address - Street 1:A23 CALLE 1
Practice Address - Street 2:URB PORTALES DE JUNCOS
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-421-6119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR080633305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service