Provider Demographics
NPI:1134291701
Name:DIAZ-COLON, NERIBELLE (MS)
Entity type:Individual
Prefix:
First Name:NERIBELLE
Middle Name:
Last Name:DIAZ-COLON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A2 CALLE 2
Mailing Address - Street 2:MONTEBELLO ESTATES
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2428
Mailing Address - Country:US
Mailing Address - Phone:787-293-4662
Mailing Address - Fax:
Practice Address - Street 1:652 AVE SAN PATRICIO
Practice Address - Street 2:URB SUMMIT HILLS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-4509
Practice Address - Country:US
Practice Address - Phone:787-792-0760
Practice Address - Fax:787-792-0635
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR546231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRQ46963Medicare UPIN