Provider Demographics
NPI:1336017185
Name:LOPEZ COLON, LIZA
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:LOPEZ 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:R955 CALLE 18 URB AULTURAS DE RIO GRANDE
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-0000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR 3 ESQUINA CARR 186 KM 26.9 SEGUNDA PLANTA
Practice Address - Street 2:BO JIMENEZ
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745-0000
Practice Address - Country:US
Practice Address - Phone:787-550-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-24
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty