=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386937647
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARMEN M COLON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2011
-----------------------------------------------------
Last Update Date | 05/19/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | RR 5 BOX 4699
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00956-9732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-799-4699
-----------------------------------------------------
Fax | 787-279-7194
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | RR 5 BOX 4699
-----------------------------------------------------
City | BAYAMON
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00956-9732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-799-4699
-----------------------------------------------------
Fax | 787-279-7194
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 3666
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------