Provider Demographics
NPI:1144939612
Name:COLON TORRES, ADELIS MARIE
Entity type:Individual
Prefix:
First Name:ADELIS
Middle Name:MARIE
Last Name:COLON TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ADELIS
Other - Middle Name:MARIE
Other - Last Name:COLON TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE
Mailing Address - Street 1:6000 MAYORAL APTS APT 30
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-3316
Mailing Address - Country:US
Mailing Address - Phone:939-254-9322
Mailing Address - Fax:
Practice Address - Street 1:6000 MAYORAL APTS APT 30
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-3316
Practice Address - Country:US
Practice Address - Phone:939-254-9322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR91670163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)