Healthcare Provider Details

I. General information

NPI: 1003962028
Provider Name (Legal Business Name): LUIS G COLON RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

K628 AVE JORGE VAZQUEZ SANES URBANIZACION VISTAMAR
CAROLINA PR
00983-1402
US

IV. Provider business mailing address

12 PASEO DE LAS FLORES URBANIZACION PRIMAVERA
TRUJILLO ALTO PR
00976-6075
US

V. Phone/Fax

Practice location:
  • Phone: 787-768-6637
  • Fax: 787-762-0780
Mailing address:
  • Phone: 787-293-2669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4466
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: