Provider Demographics
NPI:1336862812
Name:COLON, REBECCA MARIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MARIA
Last Name:COLON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12982 NW 8TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33182-2373
Mailing Address - Country:US
Mailing Address - Phone:305-310-4592
Mailing Address - Fax:
Practice Address - Street 1:12650 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1868
Practice Address - Country:US
Practice Address - Phone:305-274-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS64660183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist