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General NPI Number Information
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NPI Number | 1578950507
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Entity Type | Organization
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Legal Business Name | COLONIAL MEDICAL MANAGEMENT, CORP
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | CARR. 402, KM 1.8 BO MARIAS, ZONA INDUSTRIAL
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-229-1141
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Fax | 787-229-1131
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Provider Business Mailing Address
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Address Line | PO BOX 1716
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City | ANASCO
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State | PR
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Zip | 00610-1716
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Country | US
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Telephone | 787-229-1141
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Fax | 787-229-1131
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Authorized Official
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Title or Position | MANAGER
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Name | MR. DAVID ALICEA
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Credential |
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Telephone | 787-229-1141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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