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General NPI Number Information
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NPI Number | 1063870772
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Entity Type | Individual
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Provider Name | DR. JUANA ENID COLON
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Gender | Female
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 175 CARR PR 385 WALGREENS 9118
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 787-836-1123
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Fax | 787-836-6546
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Provider Business Mailing Address
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Address Line | PO BOX 3242 URB VALLE DE ANDALUCIA
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City | PONCE
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State | PR
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Zip | 00728-3124
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Country | US
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Telephone | 787-836-1123
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Fax | 787-836-6546
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3871
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License Number State | PR
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