Provider Demographics
NPI:1952594418
Name:ROSA-COLON, ELBA SYRAIDA
Entity Type:Individual
Prefix:MRS
First Name:ELBA
Middle Name:SYRAIDA
Last Name:ROSA-COLON
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:COND. SERENNA 500 GRAN BOULEVAR LOS PRADOS
Mailing Address - Street 2:APT. 22101
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-316-6411
Mailing Address - Fax:
Practice Address - Street 1:328 PASEO DEL PARQUE
Practice Address - Street 2:URB. EL VALLE
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-3227
Practice Address - Country:US
Practice Address - Phone:787-316-6411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1597103TC1900X
PR641235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling