Provider Demographics
NPI:1023284387
Name:COLON, CARMEN E
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:E
Last Name:COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 5 BOX 11252
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-9754
Mailing Address - Country:US
Mailing Address - Phone:787-486-5885
Mailing Address - Fax:
Practice Address - Street 1:HC 5 BOX 11252
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-9754
Practice Address - Country:US
Practice Address - Phone:787-486-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19611835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric