Provider Demographics
NPI:1447714209
Name:COLLADO JUSTINANO, SHERLEY (MD)
Entity type:Individual
Prefix:MISS
First Name:SHERLEY
Middle Name:
Last Name:COLLADO JUSTINANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SHERLEY
Other - Middle Name:
Other - Last Name:COLLADO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 365067
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-5067
Mailing Address - Country:US
Mailing Address - Phone:787-474-0333
Mailing Address - Fax:
Practice Address - Street 1:CALLE DR. GUILLERMO ARBONA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-474-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16828208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics