Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 17636 | PR |
NPI | 1013148097 |
---|---|
Provider Name | Dr. Nayraliz Colon-Nieves |
First Address | Guaynabo, PR 00969 |
Second Address | Caguas, PR 00727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2009 |
Last Update Date | 04/05/2020 |