Basic Information
| Provider Information | |||||||||
| NPI: | 1275600215 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEDINA COLON | ||||||||
| FirstName: | MAGALY | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2225 PONCE BY PASS | ||||||||
| Address2: | EDIFICIO PARRA SUITE 404 | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872900135 | ||||||||
| FaxNumber: | 7872845398 | ||||||||
| Practice Location | |||||||||
| Address1: | 2225 PONCE BY PASS | ||||||||
| Address2: | EDIFICIO PARRA SUITE 404 | ||||||||
| City: | PONCE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872900135 | ||||||||
| FaxNumber: | 7872845398 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 15859 | PR | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.