1568456200 NPI number — DR. LUIS ROBERTO COLON FERREIRA MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568456200 NPI number — DR. LUIS ROBERTO COLON FERREIRA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLON FERREIRA
Provider First Name:
LUIS
Provider Middle Name:
ROBERTO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568456200
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
V3 CALLE MONTE DEL ESTADO
Provider Second Line Business Mailing Address:
COLINAS METROPOLITANAS
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-5236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-790-8846
Provider Business Mailing Address Fax Number:
787-848-0318

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
174 CALLE LUIS BARRERAS S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAYEY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00736-4615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-263-0966
Provider Business Practice Location Address Fax Number:
787-848-0318
Provider Enumeration Date:
09/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  08969 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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