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NPI Code Detail

MEDICARE: DR. GILDRED ESMYRNA COLON M.D.

MEDICARE: DR. GILDRED ESMYRNA COLON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician4646PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
199065OTHERPRTRIPLE SSS

General Provider Information

NPI Number : 1770577082
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GILDRED ESMYRNA COLON M.D.
Provider Business Mailing Address
First Line : URB. FLORAL PARK
Second Line : 62 CALLE JOSE MARTI
City : SAN JUAN
State : PR
Zip : 00917-3104
Country : US
Telephone Number : 787-721-5424
Fax Number : 787-721-5420
Provider Business Practice Location Address
First Line : URB. FLORAL PARK
Second Line : 62 CALLE JOSE MARTI
City : SAN JUAN
State : PR
Zip : 00917-3104
Country : US
Telephone Number : 787-721-5424
Fax Number : 787-721-5420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2005
Last Update Date : 12/05/2011

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