Active NPI
Wanda Ivelisse Colon, RPH
- Pharmacist
- Carolina, PR
National Provider Identifier
1073806873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 4967
- Practice address
- PR 190 & Campo Rico
Carolina, PR 00979 - Phone
- (787) 762-1290
- NPI assigned
- May 26, 2011
- Last updated
- May 26, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 4967 | PR | Primary |
Addresses
Primary practice location
PR 190 & Campo Rico
Carolina, PR 00979
Mailing address
Urb. Palacios Reales Num 86 C-19
Toa Alta, PR 00953
Phone (787) 359-3971
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4967 | PR | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306368000000",
"number": "1073806873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. PALACIOS REALES NUM 86 C-19",
"city": "TOA ALTA",
"state": "PR",
"postal_code": "00953",
"telephone_number": "787-359-3971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PR 190 & CAMPO RICO",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00979",
"telephone_number": "787-762-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLON",
"first_name": "WANDA",
"middle_name": "IVELISSE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-26",
"last_updated": "2011-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PR",
"license": "4967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carolina, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.