Provider Demographics
NPI:1710978192
Name:COLON RIVERA, JOSE E (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:E
Last Name:COLON RIVERA
Suffix:
Gender:M
Credentials:MD
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 4709
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-4709
Mailing Address - Country:US
Mailing Address - Phone:787-882-5315
Mailing Address - Fax:787-882-5315
Practice Address - Street 1:HOSPITAL BUEN SAMARITAN
Practice Address - Street 2:4TH FLOOR
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-882-5315
Practice Address - Fax:787-882-5315
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7187207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1550OtherPREFERRED MEDICARE CHOICE
PR601052OtherMEDICARE MUCHO
PR601052OtherMEDICARE MUCHO
PRC77590Medicare UPIN