Provider Demographics
NPI:1215757398
Name:COLON LEBRON, ANNEL MARIE (OD, MSMS)
Entity type:Individual
Prefix:DR
First Name:ANNEL
Middle Name:MARIE
Last Name:COLON LEBRON
Suffix:
Gender:F
Credentials:OD, MSMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CALLE PARENTESIS
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3724
Mailing Address - Country:US
Mailing Address - Phone:787-361-5579
Mailing Address - Fax:
Practice Address - Street 1:10 CALLE AQUAMARINA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-1957
Practice Address - Country:US
Practice Address - Phone:787-258-5394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR777-479152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist