Healthcare Provider Details

I. General information

NPI: 1184734899
Provider Name (Legal Business Name): EVELYN COLON RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE CASIA
SAN JUAN PR
00921-3200
US

IV. Provider business mailing address

M1 CALLE JUNO VILLAS DE BUENA VISTA
BAYAMON PR
00956-5954
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7581
  • Fax:
Mailing address:
  • Phone: 787-279-2648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number206
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: