Provider Demographics
NPI:1386407542
Name:COLON, JUAN JAVIER (PHARM D)
Entity type:Individual
Prefix:MR
First Name:JUAN
Middle Name:JAVIER
Last Name:COLON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8805 NW 115TH CT
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2427
Mailing Address - Country:US
Mailing Address - Phone:787-203-0524
Mailing Address - Fax:
Practice Address - Street 1:8805 NW 115TH CT
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2427
Practice Address - Country:US
Practice Address - Phone:787-203-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist