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General NPI Number Information
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NPI Number | 1841279643
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Entity Type | Individual
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Provider Name | OMAIRA COLON RODRIGUEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | PONCE DE LEON AVE. 1492 CENTRO EUROPA SUITE 711
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City | SAN JUAN
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State | PR
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Zip | 00907
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Country | US
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Telephone | 787-725-2830
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 360070
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City | SAN JUAN
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State | PR
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Zip | 00936-0070
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Country | US
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Telephone | 787-640-1878
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Fax | 787-999-0273
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 14340
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License Number State | PR
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