Provider Demographics
NPI:1902091226
Name:RODRIGUEZ COLON, YAMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:YAMIL
Middle Name:
Last Name:RODRIGUEZ COLON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. ALTURAS DEL MAR ARECIFE ST.
Mailing Address - Street 2:E-7 #148
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623
Mailing Address - Country:US
Mailing Address - Phone:787-607-7773
Mailing Address - Fax:
Practice Address - Street 1:107 AVE PEDRO ALBIZU CAMPOS STE 2
Practice Address - Street 2:WEST PROFESSINAL BUILDING KM 2.8
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-7497
Practice Address - Fax:787-882-0250
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13381208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0088720ACOtherMCA
PR42398Medicare UPIN