Healthcare Provider Details

I. General information

NPI: 1649289612
Provider Name (Legal Business Name): MARIA DEL CARMEN COLON-ROIG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIA COLON-ROIG M.D.

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO FISIATRICO - DRA. MARIA DEL C. COLON ROIG BAYAMON MEDICAL PLAZA OFFICE 808
BAYAMON PR
00959
US

IV. Provider business mailing address

BAYAMON MEDICAL PLAZA OFICINA 808 CENTRO FISIATRICO
BAYAMON PR
00960
US

V. Phone/Fax

Practice location:
  • Phone: 787-785-4410
  • Fax: 787-785-4412
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number11055
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number11055
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: