MEDICARE: KARENLY COLON BURGOS PHARN 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
1	183500000X	Pharmacist	5241	PR

General Provider Information

NPI Number	:	1750675765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARENLY COLON BURGOS PHARN D

Provider Business Mailing Address
First Line	:	HACIENDA SAN JOSE 1439 COND PUERTA DEL PARQUE
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00727
Country	:	US
Telephone Number	:	787-607-1763
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 AVE RAFAEL CORDERO # FARMACIA
Second Line	:	200 AVE RAFAEL CORDERO STE 41
City	:	CAGUAS
State	:	PR
Zip	:	00725-3740
Country	:	US
Telephone Number	:	787-745-0290
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	06/07/2011

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