Healthcare Provider Details

I. General information

NPI: 1497547426
Provider Name (Legal Business Name): ASHLIE DIAZ COLON DMD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 365067
SAN JUAN PR
00936-5067
US

IV. Provider business mailing address

839 CALLE ANASCO PLAZA UNIV 2000 APT 803
SAN JUAN PR
00925-2475
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 787-326-9557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number003593
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: