Individual provider Active NPI

Antonio J. Colorado III, M.A.

  • Counseling Psychologist
  • San Juan, PR
National Provider Identifier
1063643609
Registry record updated Jul 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1849 Issued in PR
Practice address
405 Ave Hostos
San Juan, PR 00918-3014
Phone
(787) 753-9515
Fax
(787) 296-1691
NPI assigned
Jul 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1849 PR Primary

Addresses

Primary practice location

405 Ave Hostos
San Juan, PR 00918-3014

Mailing address

PO Box 367221
San Juan, PR 00936-7221
Phone (787) 753-9515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1849PRMDCounseling Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1063643609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367221",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009367221",
            "telephone_number": "787-753-9515",
            "fax_number": "787-296-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 AVE HOSTOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183014",
            "telephone_number": "787-753-9515",
            "fax_number": "787-296-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLORADO",
        "first_name": "ANTONIO",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PR",
            "license": "1849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.