1649289612 NPI number — DR. MARIA DEL CARMEN COLON-ROIG M.D.

Table of content: DR. MARIA DEL CARMEN COLON-ROIG M.D. (NPI 1649289612)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649289612 NPI number — DR. MARIA DEL CARMEN COLON-ROIG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLON-ROIG
Provider First Name:
MARIA
Provider Middle Name:
DEL CARMEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLON-ROIG
Provider Other First Name:
MARIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649289612
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BAYAMON MEDICAL PLAZA OFICINA 808
Provider Second Line Business Mailing Address:
CENTRO FISIATRICO
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00960
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CENTRO FISIATRICO - DRA. MARIA DEL C. COLON ROIG
Provider Second Line Business Practice Location Address:
BAYAMON MEDICAL PLAZA OFFICE 808
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-785-4410
Provider Business Practice Location Address Fax Number:
787-785-4412
Provider Enumeration Date:
08/07/2006

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: 174400000X , with the licence number:  11055 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: 11055 , 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)

  • Identifier: 83605 . This is a "SSS PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 83454 . This is a "MEDICARE PROVIDER NUMBER" identifier . This identifiers is of the category "OTHER".




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