Individual
MS. MIRTA COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 AVE ROOSEVELT APT 1204, SAN JUAN, PR 00917-2743
(787) 361-1977
Mailing address
121 AVE ROOSEVELT APT 1204, SAN JUAN, PR 00917-2743
(787) 361-1977
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
327
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#327
DIETITIAN LICENSE NUMBER
PR
Enumeration date
07/20/2009
Last updated
07/20/2009
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