Provider Demographics
NPI:1487263505
Name:COLON-APONTE, RICARDO JAVIER (APRN)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:JAVIER
Last Name:COLON-APONTE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EST DE LOS ARTESANOS
Mailing Address - Street 2:161 STREET SERIGRAFIA
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771
Mailing Address - Country:US
Mailing Address - Phone:787-298-1383
Mailing Address - Fax:
Practice Address - Street 1:EST DE LOS ARTESANOS
Practice Address - Street 2:161 STREET SERIGRAFIA
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-0077
Practice Address - Country:US
Practice Address - Phone:787-298-1383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3606363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3606Medicaid