Provider Demographics
NPI:1972772887
Name:COLON-RIVERA, CRISTIAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:S
Last Name:COLON-RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1854 AVE MCLEARY
Mailing Address - Street 2:APT B5
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911
Mailing Address - Country:US
Mailing Address - Phone:787-560-3423
Mailing Address - Fax:787-877-9680
Practice Address - Street 1:3 CALLE CATALINO VELAZQUEZ
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-5022
Practice Address - Country:US
Practice Address - Phone:787-560-3423
Practice Address - Fax:787-877-9680
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17018207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice