Provider Demographics
NPI:1215133111
Name:COLON MARRERO, IRIS A (MD)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:A
Last Name:COLON MARRERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 POMARROSAS, URB. SABANERA
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-9462
Mailing Address - Country:US
Mailing Address - Phone:787-714-0004
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 172 INTERIOR, KM. 7.5
Practice Address - Street 2:SECTOR CERTENEJAS II, BARRIO BAYAMON
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-469-9327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9795208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice