Healthcare Provider Details

I. General information

NPI: 1770577082
Provider Name (Legal Business Name): GILDRED ESMYRNA COLON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GILDRED ESMYRNA ZORBA M.D.

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. FLORAL PARK 62 CALLE JOSE MARTI
SAN JUAN PR
00917-3104
US

IV. Provider business mailing address

URB. FLORAL PARK 62 CALLE JOSE MARTI
SAN JUAN PR
00917-3104
US

V. Phone/Fax

Practice location:
  • Phone: 787-721-5424
  • Fax: 787-721-5420
Mailing address:
  • Phone: 787-721-5424
  • Fax: 787-721-5420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number4646
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: