Provider Demographics
NPI:1457329351
Name:COLON DE JIMENEZ, ANA L (MD FAAD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:L
Last Name:COLON DE JIMENEZ
Suffix:
Gender:F
Credentials:MD FAAD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:LIDIA
Other - Last Name:COLN-VARGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 22678
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00931-2678
Mailing Address - Country:US
Mailing Address - Phone:787-763-1612
Mailing Address - Fax:787-753-7615
Practice Address - Street 1:6 CALLE JOSE FERNANDEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4404
Practice Address - Country:US
Practice Address - Phone:787-763-1612
Practice Address - Fax:787-753-7615
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3306207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR95238COOtherTRIPLE S
PR063424OtherCRUZ AZUL
PR6603710961OtherMCS CLASSICCARE
PR216086OtherPREFERRED HEALTH
PR3306OtherCOSVI
PR3306OtherMAPFRE
PR601119OtherMEDICARE Y MUCHO MAS(MMM)
PR0300056OtherHUMANA
PR2-3306OtherMCS
PRE20114Medicare UPIN
PR601119OtherMEDICARE Y MUCHO MAS(MMM)