Active NPI
Magda Ivelisse Diaz-Colon, R.PH.
- Pharmacist
- Orlando, FL
National Provider Identifier
1619303609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS23072
- Practice address
- 9549 Trulock CT
Orlando, FL 32817-4718 - Phone
- (407) 303-2559
- Fax
- (407) 303-2768
- NPI assigned
- Sep 23, 2013
- Last updated
- Sep 23, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS23072 | FL | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PU5772 | FL |
Addresses
Primary practice location
9549 Trulock CT
Orlando, FL 32817-4718
Mailing address
9549 Trulock CT
Orlando, FL 32817-4718
Phone (407) 303-2559
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 270969 | Other | FL | NABP |
| PS23072 | Other | FL | BOARD OF PHARMACY PHARMACIST LICENSE NUMBER |
| PU5772 | Other | FL | BOARD OF PHARMACY CONSULTANT PHARMACIST |
Other names 1
- Mrs. Magda Ivelisse Colon
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 |
|---|---|---|---|
| PS23072 | FL | MD | Pharmacist |
| PU5772 | FL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379894400000",
"number": "1619303609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9549 TRULOCK CT",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328174718",
"telephone_number": "407-303-2559",
"fax_number": "407-303-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9549 TRULOCK CT",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328174718",
"telephone_number": "407-303-2559",
"fax_number": "407-303-2768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ-COLON",
"first_name": "MAGDA",
"middle_name": "IVELISSE",
"name_prefix": "Mrs.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-23",
"last_updated": "2013-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS23072",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "FL",
"license": "PU5772",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "270969",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY PHARMACIST LICENSE NUMBER",
"identifier": "PS23072",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHARMACY CONSULTANT PHARMACIST",
"identifier": "PU5772",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MAGDA",
"last_name": "COLON",
"middle_name": "IVELISSE",
"prefix": "MRS.",
"credential": "R.PH.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.