Healthcare Provider Details

I. General information

NPI: 1720914690
Provider Name (Legal Business Name): CARLOS R COLON JR. PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 AVE OSVALDO MOLINA
FAJARDO PR
00738-4013
US

IV. Provider business mailing address

260 CALLE MANUEL F ROSSY
SAN JUAN PR
00918-4020
US

V. Phone/Fax

Practice location:
  • Phone: 787-801-0081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number008266
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: