Basic Information
| Provider Information | |||||||||
| NPI: | 1861550428 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARLO - COLON | ||||||||
| FirstName: | MITZARIE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D., PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PROGRAMA DOCTORAL EN AUDIOLOGIA - EPS, U.PR | ||||||||
| Address2: | PO BOX 365067 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009365067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877582525 | ||||||||
| FaxNumber: | 7877656540 | ||||||||
| Practice Location | |||||||||
| Address1: | CLINICA DE LA ESCUELA DE MEDICINA | ||||||||
| Address2: | REPARTO METROPOLITANO SHOPPING CENTER | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877587910 | ||||||||
| FaxNumber: | 7876251966 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 04/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 592 | PR | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.