Provider Demographics
NPI:1356180418
Name:COLON VIERA, ROSAIDA
Entity type:Individual
Prefix:
First Name:ROSAIDA
Middle Name:
Last Name:COLON VIERA
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:PO BOX 70179
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8179
Mailing Address - Country:US
Mailing Address - Phone:787-619-6563
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 7702
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-9726
Practice Address - Country:US
Practice Address - Phone:787-619-6563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11186104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker