Provider Demographics
NPI:1447263165
Name:COLON-DIAZ, RAFAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:COLON-DIAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986-0647
Mailing Address - Country:US
Mailing Address - Phone:787-757-1190
Mailing Address - Fax:787-762-8881
Practice Address - Street 1:1 CALLE DOMINGO CACERES E
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-6013
Practice Address - Country:US
Practice Address - Phone:787-757-1190
Practice Address - Fax:787-762-8881
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1851208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice