1487263505 NPI number — RICARDO JAVIER COLON-APONTE APRN

Table of content: RICARDO JAVIER COLON-APONTE APRN (NPI 1487263505)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487263505 NPI number — RICARDO JAVIER COLON-APONTE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLON-APONTE
Provider First Name:
RICARDO
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1487263505
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
EST DE LOS ARTESANOS
Provider Second Line Business Mailing Address:
161 STREET SERIGRAFIA
Provider Business Mailing Address City Name:
LAS PIEDRAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-298-1383
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
EST DE LOS ARTESANOS
Provider Second Line Business Practice Location Address:
161 STREET SERIGRAFIA
Provider Business Practice Location Address City Name:
LAS PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00771-0077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-298-1383
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2020

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: 363LP2300X , with the licence number:  3606 , 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: 3606 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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