Provider Demographics
NPI:1306163720
Name:COLON RAMOS, GLORIA D (MPT)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:D
Last Name:COLON RAMOS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HH33 CALLE 40
Mailing Address - Street 2:EXT VILLAS DE LOIZA
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-4111
Mailing Address - Country:US
Mailing Address - Phone:787-616-7581
Mailing Address - Fax:787-868-7439
Practice Address - Street 1:HH33 CALLE 40
Practice Address - Street 2:EXT VILLAS DE LOIZA
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-4111
Practice Address - Country:US
Practice Address - Phone:787-616-7581
Practice Address - Fax:787-868-7439
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-24
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist