Provider Demographics
NPI:1215293295
Name:ROLON COLON, LILLIAN ENID
Entity type:Individual
Prefix:MRS
First Name:LILLIAN
Middle Name:ENID
Last Name:ROLON COLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26-37 URB. METROPOLIS
Mailing Address - Street 2:C/37
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-7415
Mailing Address - Country:US
Mailing Address - Phone:787-649-7915
Mailing Address - Fax:
Practice Address - Street 1:26-37 URB. METROPOLIS
Practice Address - Street 2:C/37
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7415
Practice Address - Country:US
Practice Address - Phone:787-649-7915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1422225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist