Basic Information
| Provider Information | |||||||||
| NPI: | 1932549680 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COLON | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 182 SP AVE WEST MAIN 500 | ||||||||
| Address2: | 3C 2 VILLAS DE BAYAMON | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00961 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872880136 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 615 STREET | ||||||||
| Address2: | BLQ 237 #21 | ||||||||
| City: | CAROLINA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00985 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877529644 | ||||||||
| FaxNumber: | 7872570770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2013 | ||||||||
| LastUpdateDate: | 06/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 2072 | PR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.