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NPI Code Detail

MEDICARE: GLORIA COLON M.D.

MEDICARE:   GLORIA  COLON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist009183PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
181624OTHERPRTRIPLES INC.
29120246OTHERPRHUMANA HEALTH CARE
36605457453OTHERPRMEDICAL CARD SYSTEM

General Provider Information

NPI Number : 1134104557
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA COLON M.D.
Provider Business Mailing Address
First Line : 3037 VIA PELICANOS
Second Line : CAMINO DEL MAR
City : TOA BAJA
State : PR
Zip : 00949-4387
Country : US
Telephone Number : 787-728-1575
Fax Number : 787-726-0402
Provider Business Practice Location Address
First Line : 252 CALLE SAN JORGE
Second Line : SUITE 504
City : SANTURCE
State : PR
Zip : 00912-3310
Country : US
Telephone Number : 787-728-1575
Fax Number : 787-726-0402
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 10/11/2012

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Directions to “ GLORIA COLON M.D.” Practice Location

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