Healthcare Provider Details

I. General information

NPI: 1295679611
Provider Name (Legal Business Name): CM FAMILY MEDICINE & WELLNESS CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR 2 KM 124 BO CAIMITAL ALTO
AGUADILLA PR
00604
US

IV. Provider business mailing address

PO BOX 488
MOCA PR
00676-0488
US

V. Phone/Fax

Practice location:
  • Phone: 787-396-4209
  • Fax:
Mailing address:
  • Phone: 787-396-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAVIER E COLON
Title or Position: OWNER
Credential: MD
Phone: 787-396-4209