Provider Demographics
NPI:1295171262
Name:RIVERA COLON, RAUL (PHD)
Entity type:Individual
Prefix:DR
First Name:RAUL
Middle Name:
Last Name:RIVERA COLON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 5611
Mailing Address - Street 2:
Mailing Address - City:OROCOVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00720-9236
Mailing Address - Country:US
Mailing Address - Phone:787-516-1623
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 5611
Practice Address - Street 2:
Practice Address - City:OROCOVIS
Practice Address - State:PR
Practice Address - Zip Code:00720-5611
Practice Address - Country:US
Practice Address - Phone:787-516-1623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4176103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling