Provider Demographics
NPI:1063721405
Name:COLON, YOLANDA (OTR)
Entity type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:
Last Name:COLON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 NW 113TH CT
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1817
Mailing Address - Country:US
Mailing Address - Phone:787-435-6685
Mailing Address - Fax:
Practice Address - Street 1:4424 NW 113 CT
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-1817
Practice Address - Country:US
Practice Address - Phone:787-435-6685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT3231174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist