Provider Demographics
NPI:1770577082
Name:COLON, GILDRED ESMYRNA (MD)
Entity type:Individual
Prefix:DR
First Name:GILDRED
Middle Name:ESMYRNA
Last Name:COLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GILDRED
Other - Middle Name:ESMYRNA
Other - Last Name:ZORBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:URB. FLORAL PARK
Mailing Address - Street 2:62 CALLE JOSE MARTI
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3104
Mailing Address - Country:US
Mailing Address - Phone:787-721-5424
Mailing Address - Fax:787-721-5420
Practice Address - Street 1:URB. FLORAL PARK
Practice Address - Street 2:62 CALLE JOSE MARTI
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3104
Practice Address - Country:US
Practice Address - Phone:787-721-5424
Practice Address - Fax:787-721-5420
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4646207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR99065OtherTRIPLE SSS
PR99065OtherTRIPLE SSS
PRD26745Medicare UPIN