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General NPI Number Information
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NPI Number | 1053926089
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Entity Type | Individual
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Provider Name | ESTEFANY COLON LOPEZ OD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | CARR #2 SECTOR LA VIRGENCITA INTER WALMART VISION CENTER
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-641-5643
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Fax | 787-230-7153
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Provider Business Mailing Address
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Address Line | PO BOX 4960
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City | CAGUAS
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State | PR
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Zip | 00726-4960
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Country | US
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Telephone | 787-641-5643
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Fax | 787-230-7153
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 773
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License Number State | PR
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