Healthcare Provider Details

I. General information

NPI: 1902503782
Provider Name (Legal Business Name): LUIS MIGUEL COLON CRUZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 07/07/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. PARKSIDE C1 CALLE PARKSIDE 4
GUAYNABO PR
00968
US

IV. Provider business mailing address

AVE SAN ALFONSO 1393 URB ALTAMESA
SAN JUAN PR
00921
US

V. Phone/Fax

Practice location:
  • Phone: 787-792-0780
  • Fax:
Mailing address:
  • Phone: 787-518-1820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8441
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: