Provider Demographics
NPI:1326895590
Name:COLON CORDERO, MICHAEL (CHIROPRACTOR)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:COLON CORDERO
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RES GABRIEL SOLER STE 61
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-1527
Mailing Address - Country:US
Mailing Address - Phone:787-951-2332
Mailing Address - Fax:
Practice Address - Street 1:606 AVE TITO CASTRO STE 113
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0203
Practice Address - Country:US
Practice Address - Phone:787-221-3978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor