Provider Demographics
NPI:1306429774
Name:COLON MARRERO, RAFAEL (NL)
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:
Last Name:COLON MARRERO
Suffix:
Gender:M
Credentials:NL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GIRALDA 92
Mailing Address - Street 2:URB. SULTANA GIRALDA 92
Mailing Address - City:GIRALDA 92
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-834-1588
Mailing Address - Fax:
Practice Address - Street 1:GIRALDA 92
Practice Address - Street 2:URB. SULTANA GIRALDA 92
Practice Address - City:GIRALDA 92
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-1588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR93175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath