Provider Demographics
NPI:1952431405
Name:COLON, JACQUELINE (AF)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:AF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 5658
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-9752
Mailing Address - Country:US
Mailing Address - Phone:787-847-0914
Mailing Address - Fax:787-847-3336
Practice Address - Street 1:HC 2 BOX 5658
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-9752
Practice Address - Country:US
Practice Address - Phone:787-847-0914
Practice Address - Fax:787-847-3336
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR002436183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR086646OtherREGISTRO AUX. FARMACIA
PR002436OtherLIC. AUXILIAR DE FARMACIA