Provider Demographics
NPI:1265426415
Name:BAEZ COLON, SONIA J (MD)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:J
Last Name:BAEZ COLON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:MIGUEL RIVERA STREET #173
Mailing Address - Street 2:ESTANCIAS DEL GOLF
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-812-6235
Mailing Address - Fax:787-812-6235
Practice Address - Street 1:1484 EMILIO FAGOT AVE
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0000
Practice Address - Country:US
Practice Address - Phone:787-840-4460
Practice Address - Fax:787-840-4460
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2022-01-25
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Provider Licenses
StateLicense IDTaxonomies
PR13179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH27302Medicare UPIN