Individual provider Active NPI

Edda A Colon, MS/PHL

  • Speech-Language Pathologist
  • Santa Isabel, PR
National Provider Identifier
1104168087
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1263 Issued in PR
Practice address
Carr 153 KM 7.5 Bo Useras
Santa Isabel, PR 00757-2762
Phone
(787) 674-4020
Fax
(787) 592-1564
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1263 PR Primary

Addresses

Primary practice location

Carr 153 KM 7.5 Bo Useras
Santa Isabel, PR 00757-2762

Mailing address

Urb. Jardines C/9 L-11
Santa Isabel, PR 00757-1924
Phone (787) 674-4020

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 Science

State licenses

LicenseStateTypeSpecialty
1263PRMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1104168087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. JARDINES C/9 L-11",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007571924",
            "telephone_number": "787-674-4020",
            "fax_number": "787-592-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 153 KM 7.5 BO USERAS",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007572762",
            "telephone_number": "787-674-4020",
            "fax_number": "787-592-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "EDDA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MS/PHL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PR",
            "license": "1263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Isabel, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.