Healthcare Provider Details

I. General information

NPI: 1609931211
Provider Name (Legal Business Name): JESSIKA APONTE COLON M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 140 KM. 63.5 BO. MAGUEYES
BARCELONETA PR
00617
US

IV. Provider business mailing address

273 CALLE 12 FLAMINGO HILLS
BAYAMON PR
00957-1775
US

V. Phone/Fax

Practice location:
  • Phone: 787-846-7784
  • Fax: 787-846-7859
Mailing address:
  • Phone: 787-614-4044
  • Fax: 787-269-0492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number14708
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: